Systems and methods for health care credit transactions

ABSTRACT

Systems, methods, and computer program media for creating, managing, backing, and transferring health care credits are described. Health care credits may be implemented as freely transferable financial instruments whose initial value can be based on costs or savings generated by an individual, or by a health care provider, that are associated with a health-related metric or a health benefiting behavior(s).

RELATED APPLICATIONS

This application is a continuation of, and claims benefit of, priorapplication Ser. No. 13/486,427 filed Jun. 1, 2012, which is acontinuation-in-part of, and claims benefit of, prior application Ser.No. 13/273,456 filed on Oct. 14, 2011, both of which are herebyincorporated by reference in their entirety. This application is relatedto the following commonly-assigned, co-pending U.S. patent applicationSer. No. 13/273,430, entitled “SYSTEMS AND METHODS FOR PROCESSING THEREDEMPTION OF HEALTH CARE CREDITS” by the same inventors; and Ser. No.13/273,366, entitled “SYSTEMS AND METHODS FOR PROVIDING HEALTH CARECREDITS TO SUBSCRIBERS” by the same inventors; both of which were filedon Oct. 14, 2011, and the entire disclosures of which are incorporatedherein by reference.

FIELD

This invention generally relates to systems and methods for health caresystems. More particularly, this invention relates to platforms andtechniques for monetizing, transferring, and exchanging creditsrepresenting health care related actions and outcomes.

BACKGROUND

Health insurance is insurance that pays for all, or a portion, of theexpenses incurred by an individual for health-related care, such asmedical care, medications, etc. Generally, a health insurance company(i.e., health insurer) provides health care benefits to an individual asspecified in an insurance policy or insurance plan, in exchange forperiodic payments or premiums. By modeling the risk of health careexpenses for a group of people that the insured belongs to (e.g.,Caucasian males aged 40-50), the insurer can calculate a premium thatprovides enough assets to pay for the health care benefits specified inthe insurance plan, should the need arise.

Because health care is expensive, health care insurance is alsoexpensive. As a consequence there are many disenfranchised people who donot have health care insurance, do not have enough health careinsurance, or do not have the correct health care insurance, becausethey cannot afford it. Moreover, because they cannot afford health care,the uninsured and underinsured often avoid seeking health care until orunless they develop acute symptoms or chronic illnesses. Often, medicalproblems that would have been easily and inexpensively solved in theearly stages have become complex and expensive to solve by the time theuninsured and underinsured seek care. Even though non-emergency careproviders often will not treat the uninsured and underinsured becausethey cannot pay, uninsured and underinsured patients nonetheless obtainexpensive health care treatments in emergency rooms that legally cannotdeny them care. The cost of caring for the uninsured and underinsured ispassed on in higher prices to insurance companies and insured patients.

A fairly new development in health care is the practice ofevidence-based medicine or evidence-based health care. Evidence-basedhealth care seeks to provide treatment, services, and medications for ahealth problem based on the best currently available evidence regardingtreatment of the health problem. The evidence may be obtained fromsources that range from highly scientific, published clinical trials toconventional wisdom. Evidence-based health care is most effective inthose areas of medical practice that have been frequent subjects ofscientific studies, usually from clinical trials; i.e., those areas thathave accumulated the most evidence that is accessible to medicalpractitioners.

By systematically and scientifically identifying effective, ineffective,and harmful treatments, evidence-based health care may reduce healthcare costs by reducing expenditures on ineffective and harmfultreatments.

There are several novel improvements that may be made to conventionalhealth care payment systems and health insurance, as well asimprovements to evidence-based health care.

SUMMARY

Disclosed are systems, methods, and computer-executable media forfacilitating health care credit transactions, which perform operationsfor, and/or include means for, receiving via a network, at a serversystem, information indicating health care credits calculated andawarded based on data indicative of individuals' health or behaviorsaffecting individuals' health, associating the health care credits withentities by updating, at a database in communication with the serversystem, profiles or data files associated with the entities, enablingaccess, over the network, to one or more accounts containing the healthcare credits, receiving via the network, at the server system a firstindication, the first indication indicating a desire or permission totransfer an interest in one or more health care credits, receiving viathe network, at the server system a second indication, the secondindication indicating a desire to receive the interest in the one ormore health care credits, and in response to the first indication andthe second indication, executing, using the server system and thedatabase, a transaction to transfer the one or more health care creditsfrom an account associated with the first indication.

For other variants, also disclosed are systems, methods, andcomputer-executable media for providing a health care credit program,which perform operations for, and/or include means for, receiving, overa network, data indicative of a metric of an individual's health or abehavior affecting the individual's health, processing the data tocalculate a health care credit amount to award the individual, based onthe metric or the behavior, associating with the individual a healthcare credit corresponding to the health care credit amount, by updatinga profile or data file associated the individual, and enabling theindividual to receive value associated with the health care credit byenabling the individual to access, over a network, an account containingthe health care credit, and use the health care credit as a transferablefinancial instrument.

For yet other variants, also disclosed are systems, methods, andcomputer-executable media for providing a health care credit program,which perform operations for, and/or include means for, receiving, overa network, data indicative of a metric of an individual's health or abehavior affecting the individual's health, processing the data tocalculate a health care credit amount to award the individual, based onthe metric or the behavior, associating with the individual a healthcare credit corresponding to the health care credit amount, by updatinga profile or data file associated the individual; and creating atransferable financial instrument associated with the health care creditthat is recognized as having value and convertible to other forms ofvalue.

For still other variants, also disclosed are systems, methods, andcomputer-executable media for providing health care credit markettransactions, which perform operations for, and/or include means for,receiving, over a network, data indicative of a metric of the health ofa plurality of individuals or behaviors affecting the health of aplurality of individuals, processing the data to calculate a health carecredit amount to award to one or more of the individuals, based on oneor more of a metric or a behavior identified in the data, associatingwith one or more of the individuals a health care credit correspondingto a respective health care credit amount, by updating a profile or datafile associated the corresponding individual, creating a plurality oftransferable financial instruments associated with the health carecredits, wherein the transferable financial instruments are payable tothe one or more of the individuals, and enabling individuals to buy,sell, transfer, or use the transferable financial instruments byenabling individuals to access the health care credits over a network.Additional variants are also disclosed.

For still other variants, a method, implemented using a computingsystem, is disclosed for health care credit transactions. The methodincludes receiving, at a server system over a network, informationindicating health care credits calculated and awarded based on dataindicative of individuals' health or behaviors affecting individuals'health. The method further includes updating, at a database provided incommunication with the server system, a profile or data file associatedwith the individuals, for associating with the individuals health carecredits defined by the received information. The method further includesenabling value associated with health care credits to be received byenabling the access, over a network, to an account containing the healthcare credits. The method further includes receiving, at the serversystem over a network, an indication of a desire or permission to conveyan interest in one or more health care credits; and receiving, at theserver system over a network, an indication of a desire to purchase ortransfer health care credits. In one embodiment, the server system andthe database are configured to execute a transaction to convey thehealth care credits or their value to recipients as desired andpermitted and update an account to reflect the results of thetransaction.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments and implementationsof the present disclosure and together with the description, serve toexplain the embodiments and implementations. Wherever convenient, thesame reference numbers may be used to refer to the same or likefeatures.

In the drawings:

FIG. 1 is a block diagram of exemplary health care credit accounts,consistent with the principles of the invention;

FIG. 2 is a flowchart of an exemplary process for managing a health carecredit account, consistent with the principles of the invention;

FIG. 3 is a block diagram of an exemplary system for exchanging healthcare credits, consistent with the principles of the invention;

FIG. 4 is a flowchart of an exemplary process for exchanging health carecredits, consistent with the principles of the invention;

FIG. 5 is a block diagram illustrating an exemplary system for managingdata and providing derivative securities related to health careinformation, consistent with the principles of the invention;

FIG. 6 is a flowchart of an exemplary process for managing a derivativesecurity related to health care credits, consistent with the principlesof the invention;

FIG. 7 is a block diagram showing an exemplary system for transferringand exchanging health care credits, consistent with the principles ofthe invention;

FIG. 8 is a flowchart of an exemplary process for managing a derivativesecurity related to the transfer of health care credits, consistent withthe principles of the invention; and

FIG. 9 is a block diagram illustrating an exemplary computing systemsuitable for implementing embodiments consistent with the principles ofthe invention;

FIG. 10 is a block diagram of an exemplary health care credit andexchange system, consistent with the principles of the invention;

FIG. 11 is a block diagram of an exemplary subsystem of an exemplaryhealth care credit and exchange system, consistent with the principlesof the invention;

FIG. 12 is an exemplary process for converting non-transferableincentive points earned in a health care plan into freely transferablehealth care credits (“HCCs”), consistent with embodiments of theinvention;

FIG. 13 illustrates an example of deriving a par value for ahealth-related behavior based on the value of other health-relatedbehaviors in relation to a standard reference, consistent withembodiments of the invention;

FIG. 14 is a block diagram of an exemplary system for transferring HCCsto an individual(s) that is unable to pay for health care products andservices, consistent with embodiments of the invention;

FIG. 15 is a flowchart of an exemplary process for facilitating healthcare credit transactions, consistent with embodiments of the invention;

FIG. 16 is a flowchart of an exemplary process associated with a healthcare credit program, consistent with embodiments of the invention;

FIG. 17 is a flowchart of an exemplary process associated with a healthcare credit program, consistent with embodiments of the invention;

FIG. 18 is a flowchart of an exemplary process associated with a healthcare credit market, consistent with embodiments of the invention; and

FIG. 19 is a diagram illustrating an exemplary system for creating,transferring, and backing health care credits, consistent withembodiments of the invention.

DETAILED DESCRIPTION Overview

Good health behavior is illiquid in the United States, and thatilliquidity costs the United States economy hundreds of billions ofdollars every year. Millions of Americans pay for much more health carecoverage than they ever use. Millions more Americans cannot afford thehealth care they need, and millions more still consider themselvesentitled to health care that they are not paying for. The health caresystem in the United States is suffering from soaring costs, lack ofaccountability, and limited access to alternative payment mechanisms.Medicare and Medicaid reflect how exposed the U.S. Government and statesare to these inefficiencies. One fundamental cause of the problem is thelack of a “market” for good behavior. There is currently no way for goodbehavior to be shared or transferred in the system to increaseaccountability and “ownership” of choices that enhance health and savemoney. With little ability to control demand, employers and insuranceplans are in effect limiting supply by, e.g., capping benefits. Thesecaps increasingly come in the form of incentives for employees orsubscribers to achieve greater wellness. However, the incentives areunlikely to motivate the people who cost the system the most—those withchronic conditions and those who lack the wherewithal to engage inhealthy behaviors.

In view of the problems outlined above, various embodiments of a healthcare credits and exchange system are disclosed for creating a market forgood health-related behavior by addressing the need for transferableincentives. In various implementations of a system, credits can beearned, purchased, traded, donated, or otherwise exchanged. For example,a son can sell the credits he has earned to help his mother pay forcancer treatment. A sister can transfer her credits to her sibling tohelp him pay for needed pharmaceutical therapeutics. A working, singlemother who does not qualify for health insurance can obtain care for herchildren via health care credits donated by a philanthropicorganization. In some embodiments, the credits may be securitized ormonetized to enable either their transfer or a way to trade onunderlying data the credits represent, such that not only would healthybehaviors and choices be rewarded, the rewards would be tradable andobtainable by people in the system who are unable to engage in healthybehaviors and choices.

Some of the various embodiments consistent with the present disclosurecreate and utilize Health Care Credits (“HCCs”). Generally, a “healthcare credit,” as used herein, can refer to an award, reward, or othertype of credit provided to an individual that rewards the individual forgood health and/or healthy behaviors, as well as incentivizes theindividual to maintain and/or improve their health level. In variousembodiments, health care credits have intrinsic value because they canbe used and accepted as a payment for health care services received bythe individual, thus monetizing the health care credits or using thecredits as a sort of currency. Further, the health care credits can befreely transferable, sellable, conveyable, and/or the like, to otherindividuals, subscribers, and/or entities and exchanged for goods andservices. Still further, the health care credits can be securitized.Moreover, the health care credits can be bought, sold, and exchanged ina market-type environment comprising authorized agents, brokers,channels, exchanges and/or other entities or components.

Various implementations of HCCs provide several advantageousimprovements to current health care systems. For example, awarding HCCsto individuals (e.g., patients) and/or health care providers (e.g.,physicians) provides a direct incentive to maintain or improve healthfor these participants in the health care system. For instance, apatient may be awarded HCCs for achieving an improved health leveloutcome, such as a reduced cholesterol level or BMI. Similarly, aphysician may earn HCCs for formulating the regimen that the patientsuccessfully followed to produce the improved health level outcome,(e.g., increased exercise and a prescription for a cholesterol-reducingmedication). HCCs may also incentivize behaviors in the preventativehealth area, such as awarding HCCs to patients who engage in healthybehaviors (e.g., exercise, regularly take medication, etc.), even if thepatient's health level does not necessarily show improvement, butinstead remains the same (e.g., cholesterol level does not increase).

Health insurance companies realize benefits for using HCCs as incentivesbecause their subscribers/members/insureds achieve better health,resulting in their using use less health care services overall and usingmore inexpensive preventive care services while requiring fewerexpensive acute, chronic, and emergency care services, all of whichreduce costs for the insurer.

Another improvement provided by HCCs is that they monetize improvedhealth outcomes and behaviors as an independent economic value, whichopens up a range of uses, including opportunities to earn future healthcare insurance coverage during present periods when an individual ishealthy. For example, young, healthy people, who typically need few ifany health care services during their early years of coverage, may beawarded HCCs while young and achieving high levels of good health, andthey may save the HCCs for later use, “spend” the HCCs right away, orconvert them to cash. For instance, young healthy people, who generallypay much more in health insurance premiums than they incur in healthcare costs during most of their lives, may exchange HCCs with theirinsurer immediately to reduce their health care insurance premiums orsell them for cash.

For an example regarding saved HCCs, later in life, when health problemsstart to affect the formerly young people, they may use saved HCCs toreduce their later, more expensive insurance premiums, or to pay forhealth care services not covered by insurance. Another advantageouseffect of awarding HCCs for healthy behavior in young individuals is anoverall reduction in health care treatments throughout the entire healthcare system as young people are incentivized early on to engage inhealthy behaviors, which makes it less likely they will develop medicalproblems and unhealthy habits later in life.

Another improvement provided by various embodiments of HCC systems is inproviding techniques and mechanisms for transferring improved healthoutcomes between health systems. For example, HCCs earned with onehealth care insurer may be saved or exchanged and used with a differenthealth care insurer because the health improvements and benefits for anindividual, which are represented by the HCCs earned by that individual,remain with the individual, thus reducing costs for a health insurer,regardless of which insurer the individual is contracting with at anyparticular time.

Yet another improvement provided by various embodiments of HCC systemsis in providing techniques and mechanisms for tracking and trading onspecific health care treatments and interventions. For example, the datacollected, stored, and analyzed in connection with treatments, patientbehaviors and activities, and measured health outcomes in order todetermine amounts of HCCs to award to each individual patient may becombined with data from many other individuals and analyzed to determinethe effects of the health care treatments and interventions on thegroup. Some embodiments may provide a novel tradable contract orsecurity (e.g., a derivative security) having a value related to theeffects of specific health care treatments or interventions.

Health Care Credit Accounts

As noted above and explained in greater detail in the relatedapplications which are incorporated by reference into this application,in various embodiments health care credits are valuable currency-likeentities that may be earned for beneficial health-related behaviors andpositive and/or improved health-related outcomes. In variousembodiments, HCCs may be exchanged for value, for example to offsethealth insurance premiums, saved for use later, exchanged for eitherhealth-related or non-health-related goods or services, gifted, tradedor sold through a broker, etc. In most embodiments, accounts areprovided to hold, transfer, and exchange HCCs.

FIG. 1 is a block diagram of exemplary health care credit accounts,consistent with the principles of the invention. In the embodiment of asystem of accounts 100 shown in FIG. 1, an insurance company orinsurance plan 130 may establish and manage a health care provider HCCaccount 133 and a patient HCC account 136 that are used by a health careprovider 110 (e.g., a physician) and a patient 115, respectively. Insome embodiments, insurance plan 130 may be a government-sponsoredhealth care insurance program, such as Medicare, Medicaid, Children'sHealth Insurance Program (CHIP), military health care programs(TriCare), or state health care programs. As discussed in the relatedapplications referenced above, insurance plan 130 may place HCCs inaccount 133 for HC provider 110 according to data 111 provided by HCprovider 110 documenting beneficial health regimens and positive healthoutcomes related to patient 115 under the care of HC provider 110.Similarly, insurance plan 130 may place HCCs in account 136 for patient115 according to data 112 provided by HC provider 110 documentingbeneficial health regimens and positive health outcomes related topatient 115 under the care of HC provider 110. In the embodiment shown,data 112 is based on data 116 provided HC provider 110 by patient 115.

Accounts 133 and 136 may also received HCCs from sources other thaninsurance plan 130. For example, as shown in FIG. 1, HCCs may betransferred 151 to accounts 133 and 136 from other sources of HCCs 150,which include sources such as HCC accounts maintained by other insurancecompanies, HCC brokerage accounts, employers, etc., from which HCCs maybe earned, awarded, bought, inherited, gifted, given as an employermatch, given as a credit-usage or other promotional reward, or otherwiseconveyed.

As shown, a non-insurance entity 140, such as a brokerage, investmentfirm, bank, or company set up specifically to provide HCC accounts, mayestablish and manage HCC accounts, such as an individual HCC account 143and an individual HCC account 146. As shown in this example, a personhaving no relationship to any insurance company, (such as Individual120), may nonetheless have a health care credit account, (such asindividual HCC account 146). As represented by dashed lines 117 and 121in the embodiment shown, individual HCC account 143 is controlled by andmaintained for patient 117, and individual HCC account 146 is controlledby and maintained for individual 120.

Accounts 143 and 146 may receive/transfer 141 HCCs from/to insuranceplan 130 according to the directions of patient 115 and individual 120,respectively. Similarly, accounts 143 and 146 receive/transmit 152 HCCsfrom/to other sources of HCCs 150 according to the directions of patient115 and individual 120, respectively.

One of ordinary skill in the art will recognize that system 100 depictedin FIG. 1 is an exemplary, generalized illustration and that componentsand features may be added to, removed from, or modified within system100 without departing from the principles of the invention. For oneexample, patient HCC account 136 may be removed, such that the onlyaccount associated with patient 115 is individual HCC account 143, andsuch that HCCs awarded to patient 115 by insurance plan 130 aredeposited directly into individual HCC account 143 by insurance plan130. For another example, in some embodiments, a single health careaccount may be provided for a group of individuals (e.g., a family)instead of only a single individual. In such embodiments, positivehealth behaviors by any member of the group (e.g., eating better andlosing weight or reducing BMI by an obese child) may earn HCCs that maybe used by other members of the group (e.g., used by a parent of theobese child to reduce the cost of medications).

FIG. 2 is a flowchart of an exemplary process 200 for managing a healthcare credit account, consistent with the principles of the invention. Insome embodiments, process 200 may be implemented using a computingsystem by an entity functioning as a HCC account provider and/or an HCCaccount servicer, such as an insurance company 130 or a non-insuranceentity 140, as shown in FIG. 1. In the embodiment shown in FIG. 2,process 200 begins with receiving a credit that represents animprovement in health (stage 205), such as an HCC as describedpreviously. In various embodiments, the credit may transferred ortransmitted from an HCC account, (such as accounts 133, 136, 143, or 146of FIG. 1), or the credit may be earned from, or awarded, originated, orcreated by an entity that seeks to reward and incentivize beneficialhealth-related behavior and care, such as an insurance company,government agency, or employer. In various implementations of thisstage, the credit may be received in the form of electronic signals orelectronic digital data.

At stage 210, process 200 stores the credit, which represents animprovement in health, in an account controlled by an entity. In someembodiments, the account may be a health care provider HCC account 133controlled by an HC provider 110, a patient HCC account 136 controlledby a patient 115, or an individual HCC account 146 controlled by anindividual 120, or the like, as shown in FIG. 1. In various embodiments,the entity may be an individual, including an insured individualenrolled in a health insurance plan, or a legal entity, such as a trust,corporation, non-profit organization, etc. In various implementations,the credit may be stored in the form of electronic digital data on acomputer readable medium.

At stage 215, process 200 deducts a credit from the account according toan instruction from the entity that controls the account. For oneexample with reference to FIG. 1, non-insurance entity 140 may deduct acredit(s) from individual HCC account 143 according to an instruction117 from patient 115, so that the credit(s) can be used to reduce ahealth insurance premium owed to insurance plan 130. In variousimplementations, the credit, (which represents an improvement inhealth), may be deducted by reducing an electronic value representingthe amount of HCCs held in the account.

Process 200 next transfers the deducted credit(s) according to theinstruction from the entity controlling the account and ends. In theembodiment shown, process 200 first determines whether the credit is agift (stage 220). If the credit is a gift, (stage 220, Yes), thenprocess 200 transfers the credit to a gift recipient (stage 225), suchas to the account of a family member. For example, a healthy husband maytransfer credits he has accumulated to the account of his wife whorequires an expensive medication whose cost has exceeded the maximumbenefit limit of her health insurance policy, allowing the wife to usethe credits to offset the continuing cost of the medication. Thus, thewife obtains a benefit from the husband's good health (and correspondinglack of expense to the husband's health insurer) as represented in theform of the husband's health care credits. This is another exemplaryimprovement over conventional health care systems wherein one individualcannot benefit in any way from another individual's healthy behaviorsand outcomes.

If the credit is not a gift, (stage 220, No), then process 200 transfersthe credit to an entity that provides, in exchange, goods, services(e.g., a reduction to a health insurance premium), cash, or the like to,or for the benefit of, the entity that controls the account (stage 230).In various implementations, the credit(s), (which represents animprovement in health), may be transferred in the form of electronicsignals or electronic digital data.

One of ordinary skill in the art will recognize that process 200depicted in FIG. 2 is an exemplary, generalized illustration and thatstages and features may be added to, removed from, or modified withinprocess 200 without departing from the principles of the invention. Forone example, a stage may be added to process 200 wherein deductedcredits are removed or disposed of, instead of being transferred toanother account, such as in the case where a credit held in an accountprovided by an insurance company (e.g., patient HCC account 136 providedby insurance company 130), is used to reduce a health insurance premiumcharged for a policy underwritten by that same insurance company.

Health Care Credit Exchange

As explained in the related applications, various embodiments of healthcare credit systems award something of value, HCCs, to individuals(patients, insureds, etc.) for beneficial health-related behaviors andoutcomes. This is an improvement over conventional health care systemsbecause an individual's health level and health-related behaviors do notsignificantly financially impact an individual in conventional systems.For example, when an already-insured individual gains weight or ceasesto exercise in a conventional health care system, these actions do notsignificantly increase the individual's premium or significantly reducesome other financial benefit. Conversely, when an already-insuredindividual reduces their BMI, reduces cholesterol level, or starts anexercise program, these actions do not significantly decrease theindividual's premium or increase some financial benefit. Individualshave little incentive to be healthy, because their costs in aconventional system are the same whether they act in a healthy manner ornot.

In contrast, health care credit systems consistent with the presentdisclosure may immediately discourage unhealthy actions by reducing oreliminating the amount of HCCs awarded to the individual. If theindividual is using HCCs to reduce their premiums, then this effectivelyraises their premiums. Moreover, various embodiments may further improveover conventional health care systems by providing exchanges or marketswhere HCCs may be bought and sold, which effectively allow sellers toconvert HCCs into cash. In such embodiments, reducing or eliminating HCCawards discourages unhealthy behaviors because the affected individualssuffer the financial loss of not being able to sell their HCCs for cashon an exchange.

FIG. 3 is a block diagram of an exemplary system 300 for exchanginghealth care credits, consistent with the principles of the invention. Inthe embodiment shown, system 300 includes an HCC exchange 340, which isa market that is designed for the sale and purchase of health carecredits issued by an entity or entities. In various embodiments, issuingentities may be health insurance companies, government agencies, or thelike. In various embodiments, HCC exchange 340 may sell and buy HCCsand/or securities derived from HCCs. In various embodiments, HCCexchange 340 may be implemented as a computerized market to trade healthcare credits, which represent an improvement in health. In someembodiments wherein the HCCs issued by different health insurers areessentially the same regardless of issuer, HCC exchange 340 may beimplemented in a manner consistent with the NASDAQ™ market for tradingstocks. In other embodiments wherein the HCCs issued by different healthinsurers have different intrinsic values and/or are valued differentlydepending upon issuer, HCC exchange 340 may be implemented in a mannerconsistent with the FOREX™ market for trading currencies.

As shown, sellers of HCCs may have HCC accounts provided and maintainedby insurance plans 310, 315 and/or by non-insurance entities 320, 325.In some instances, sellers may utilize a broker 330 to interact with HCCexchange 340, for example by transferring HCCs from an insurance planaccount 315 or a non-insurance entity account 320 into a brokerageaccount 330, from which the HCCs may be sold on exchange 340. In variousembodiments, brokerage account 330 may also include a cash component formanaging money received in exchange for HCC credits.

Similarly, buyers of HCCs may have HCC accounts provided and maintainedby insurance plans 360, 365 and/or by non-insurance entities 370, 375.In some instances, buyers may utilize a broker 350 to interact with HCCexchange 340, for example by transferring HCCs or cash from an insuranceplan account 365 or a non-insurance entity account 370 (e.g., a bankaccount) into a brokerage account 350, from which the HCCs may be boughtvia exchange 340. In various embodiments, brokerage account 350 mayinclude both a cash component for managing money paid in exchange forHCC credits, and an HCC credit component for receiving and storingpurchased HCCs.

In various embodiments an individual or entity controlling a buyeraccount 360-375 may place an order to purchase one or more HCCs bysubmitting a bid or a request to purchase the HCC to broker 350 or HCCexchange 340 via a computer network or phone line, as is known in theart of exchange trading. The bid order may be logged into a computerizeddatabase and matched with an ask, i.e., an offer to sell one or moreHCCs by HCC exchange 340, as is known in the art of exchange trading.

In the embodiment shown in FIG. 3, sellers and buyers may also interactdirectly with HCC exchange 340 without using a broker. As shown, sellershaving accounts with an insurance plan 310 or a non-insurance entity 325may offer HCCs for sale on HCC exchange 340, where the HCCs may bebought by buyers having accounts with an insurance plan 360 or anon-insurance entity 375. In such embodiments, HCC accounts 310, 325,360, and 375 may include both a cash component for managing moneypaid/received in exchange for HCC credits, and an HCC credit componentfor transmitting, receiving and/or storing purchased HCCs. In some suchembodiments, HCC exchange 340 may be implemented as a computerizedonline trading platform for HCC, which represent an improvement inhealth, in a manner consistent with the eBay™ trading platform.

In various embodiments, HCCs purchased or received by individual(s),such as the owners of buyer accounts 360-375, may be utilized by theindividual(s) to fully or partially pay for health-care related servicesand goods in lieu of cash or insurance. For example, if an individualdetermines or is advised that he or she requires medical care, where thecost of the medical care is not covered in full or in part by theindividual's insurance plan, then the individual may purchase HCCs on anHCC exchange and use the HCCs to pay for the medical care. Or, anindividual may choose to utilize HCCs to pay for medical care in lieu ofinsurance in order to gain some other benefit, such as avoiding anincrease in insurance premiums.

One of ordinary skill in the art will further recognize that system 300depicted in FIG. 3 is an exemplary, generalized illustration and thatcomponents and features may be added to, removed from, or modifiedwithin system 300 without departing from the principles of theinvention. For example, one of ordinary skill will recognize that selleraccounts 310, 315, 320, 325 may also be used to buy HCCs on HCC exchange340, and similarly buyer accounts 360, 365, 370, 375 may also be used tosell HCCs on HCC exchange 340. For another example, one of ordinaryskill will also recognize that seller accounts 310, 315, 320, 325 andbuyer accounts 360, 365, 370, 375 are not limited to being owned orcontrolled only by individual persons. In some embodiments HCC accountsmay be owned or controlled by corporations or other legal entities,which may, for example, wish to purchase HCCs that can be awarded totheir employees.

FIG. 4 is a flowchart of an exemplary process 400 for exchanging healthcare credits, consistent with the principles of the invention. In someembodiments, process 400 may be implemented using a computing system byan entity providing a market to buy and/or sell HCCs, such as HCCexchange 340, as shown in FIG. 3. In the embodiment shown in FIG. 4,process 400 begins with receiving, from an entity, an offer to exchangea credit(s) that represents an improvement in health, (e.g., an HCC).For example, the offer may be an offer to sell an HCC for a specifiedminimum amount of cash, an offer to buy an HCC for a specified maximumamount of cash, an offer to sell an HCC for the current market price, anoffer to buy an HCC for the current market price, or an offer to swap aspecified quantity of one type of HCC for a specified quantity ofanother type of HCC, (e.g., swap 1.0 HCC issued by Blue Cross BlueShield for 2.5 HCCs issued by Medicare). In various embodiments, theentity may be an individual that has an HCC account, such as HCCaccounts 310, 325 or brokerage account 330. In various implementations,the offer to exchange a credit(s) may be received in the form ofelectronic signals or electronic digital data representing a buy orderor a sell order.

At stage 420, process 400 identifies a reciprocal offer(s) to exchangethe credit that represents an improvement in health. For example, ifprocess 400 has received an offer to sell 100 HCC for $1.00 each atstage 410, stage 420 may identify one or more offers to buy 100 HCC forat least $1.00 each. In various embodiments, the identification of areciprocal offer(s) may be implemented by a computing system thatmatches buy and sell orders according to price, quantity, and otherfactors.

In various implementations, there may be no reciprocal offer thatmatches a newly received offer to exchange HCCs and/or the offer toexchange may be an offer to buy or sell HCCs at the current marketprice. In either case, stage 420 may determine that the appropriatereciprocal offer is a pending offer that is nearest to the price desiredby the entity, or the pending offer that is nearest in price to the lastcompleted exchange of the same type of HCC credit (e.g., the lastcompleted trade on a HCC exchange 340).

In some embodiments, HCCs created by different health insurers may havedifferent characteristics, which may cause them to have different valuesfrom each other, intrinsically and/or according to their market priceson a market administered by an HCC exchange 340 implementing process400. For example, consider the case where a first insurer, for instanceTriCare insurance, awards HCCs to its insureds such that 100 TriCareHCCs may be exchanged for a $100 reduction in an insured's TriCareinsurance premium, and/or exchanged for goods and services from vendorsthat TriCare has contracted with at a rate of one dollar per TriCareHCC. Consider further a second HCC insurer, for instance KaiserPermanente™, that awards HCCs to its insureds such that 100 Kaiser HCCsmay be exchanged for a $50 reduction in an insured's Kaiser insurancepremium and/or exchanged for goods and services from vendors that Kaiserhas contracted with at a rate of 75 cents per Kaiser HCC. In some suchembodiments, there may also be differences in how many HCCs each insurerawards for the same or similar healthy outcomes or actions by itsinsureds. Competing insurers may use these and other characteristics oftheir HCC programs to attract customers.

In such a case, the best reciprocal offer on the market identified bystage 420 for exchanging Kaiser HCCs for TriCare HCCs may be an offer toexchange 1.5 Kaiser HCCs for 1 TriCare HCC, or to exchange 2.0 KaiserHCCs for 1 TriCare HCC, both of which reflect the relative intrinsicvalues of the HCCs. Or, the exchange rate on the market may vary greatlyfrom the relative intrinsic values of the HCCs due to the relativesupply and demand of the two types of HCCs in this example. Similarly,individuals offering to sell the two types of HCCs for cash may besubject to the price set by the market based on supply and demand foreach of the two types of HCCs, analogous to foreign currency exchanges.

In other embodiments, HCCs created by different health insurers may havesubstantially uniform characteristics, regardless of the insurer thatissued them. For example, all insurers may allow their insureds toexchange their HCCs on a one-to-one dollar basis for a reduction in ahealth insurance premium. In some such embodiments, HCCs may be fungiblewhen traded on a market administered by an HCC exchange 340 implementingprocess 400. In such embodiments, the primary type of market transactionmay be exchanging HCCs for cash, where the reciprocal offers (stage 420)are at a price determined by the market based on supply and demand forHCCs overall, analogous to stock exchanges wherein an HCC is a securitylike a share of stock.

As shown in the embodiment of FIG. 4, process 400 next exchanges thecredit according to the reciprocal offer (stage 430). Continuing theprevious example with respect to this stage, process 400 may deduct 100HCC from the account (e.g., insurance-plan-managed account 310,non-insurance-entity-managed account 325, or brokerage account 330) ofthe entity that submitted the sell offer for 100 HCC at $1.00 each, anddeduct $100 for the account(s) (e.g., insurance-plan-managed account360, non-insurance-entity-managed account 375, or brokerage account 350)of the entity(ies) that submitted the reciprocal buy offer(s) of $100for 100 HCC.

Process 400 then provides the proceeds of the exchange to the entitythat transmitted the original offer (stage 440) and then ends. Againcontinuing the previous example, process 400 may transmit the $100deducted from the account(s) of the entity(ies) that submitted thereciprocal buy offer(s) of $100 to the entity that transmitted theoriginal sell offer referenced in stage 410.

One of ordinary skill in the art will recognize that process 400depicted in FIG. 4 is an exemplary, generalized illustration and thatstages and features may be added to, removed from, or modified withinprocess 400 without departing from the principles of the invention. Forexample, a stage may be added to process 400 wherein the proceeds of theexchange are provided to the entity associated with the reciprocal offer(e.g., the buyer that fills a sell order is provided with the HCCs thatwere purchased).

Health Care Tracking Data and Derivatives

Health care credit systems consistent with the present disclosureprovide improved health data gathering and management, which fits wellwith evidence-based health care practices, and has other novel uses. Invarious embodiments, to determine whether and how many HCCs to award toindividuals, insurers or other HCC administrators or awarders analyzehealth care data provided by the treating health care provider (e.g.,physician). In some embodiments, this same data may be used for variousother purposes in addition to administering HCC awards.

For example, the health care data may be used to track over time andevaluate health care treatment regimens and outcomes, including withrespect to specific demographic patient groups. Such tracking data maybe used to identify marginally effective and ineffective treatmentregimens and discourage their use among health care providers, whichwould provide another improvement over current health care systemwherein health care providers are often rewarded based on the amount oftreatments they provide (i.e., they are paid per treatment), regardlessof effectiveness. In some embodiments, such tracked information may beused as the basis for a derivative security having a value that isdirectly related to a specific health care outcome and that provides anovel way to monetize health care treatments.

FIG. 5 is a block diagram illustrating an exemplary system 500 formanaging data and providing health care derivative securities related tohealth care information, consistent with the principles of theinvention. In various embodiments, a health care derivative may be asecurity whose price or value is dependent upon or derived from one ormore underlying “assets,” where the assets are in the form of accurate,current information relating to health care problems, treatments,outcomes, effectiveness, usages, and the like. In some embodiments, thederivative itself may simply be a contract between two or more partiesthat specifies its value at a future date dependent upon condition(s) ofthe underlying information. The value of a derivative at any point intime before its expiration is determined by fluctuations in theunderlying data with respect to desired conditions—in this case by thechanges and content of the underlying health care data—and the marketdemand. In various embodiments, a health care derivative may be tradableon an exchange or over the counter.

As shown in the embodiment of FIG. 5, health care providers 110 mayimplement a treatment regimen or health care activity regimen 510 withpatients 115, as described in more detail in the related applications.

As the treatment regimen 510 is ongoing, health care provider 110gathers health care data 515 documenting the patient 115, the healthcharacteristics and/or problem(s), the treatment(s), the outcome(s),etc. In various embodiments, data documenting the patient may includeinformation regarding characteristics such as race, sex, age, height,weight, address, occupation, family history, habits, social history, andthe like. In various embodiments, data documenting the patient's healthcharacteristics or problems may include information describing theproblem(s) currently being treated (heart disease, cancer, broken bone,migraine headaches, high cholesterol, high BMI, etc.) including baselineand continuing measurements (e.g., artery blockage measurements, tumorsize and growth, fracture healing, headache frequency and intensity,blood pressure, cholesterol level, etc.), and the like. In variousembodiments, data documenting the patient's treatment regimen mayinclude information describing medications and usages, surgeries orother procedures, appliances used (e.g., stents, etc.), therapyroutines, diet, exercise, and the like. In various embodiments, datadocumenting the patient's outcome(s) may include information describingthe result of each treatment, for example, cured, artery blood flowincreased 70%, fracture 50% healed, headache frequency reduced 10%,cholesterol lowered by 30%, and the like.

As shown in the embodiment of FIG. 5, health care provider 110 provideshealth care data 515 to a data repository 520. In various embodiments,data repository 515 may be implemented by a database server or othercomputing system for maintaining and accessing data.

As shown, account providers 560, such as insurance plan 130 ornon-insurance entity 140, also provide data to data repository 520, suchas health care credit flow data 565. In some embodiments, health carecredits flow data 565 includes information describing transfers of HCCsfrom one account to another and describing the accounts involved, aswell as information regarding HCCs exchanged for goods, services, etc.,and the entities involved. In such embodiments, health care credits flowdata 565 may indicate, for example, the amount of HCCs that are beingsold for cash, the amount of HCCs that are being exchanged for goods andservices of contracted vendors, the amount of HCCs that are beingexchanged for insurance premium reductions, and the like.

Also as shown, health care credit awarders 530 are connected to, and mayaccess, the data in data repository 520. In various embodiments, healthcare credit awarders 530 include insurance plans/companies 130, whichmay award HCCs to individuals, such as patients 115, as an incentive toact in a health-beneficial manner and for achieving positive healthoutcomes, as explained in detail in the related applications. Healthcare credit awarders 530 may read and analyze HC data 515 stored in datarepository 520 to determine whether patients 114 have engaged inrewardable activities and/or have achieved positive health outcomes. Invarious embodiments, health care credit awarders 530 may also read andanalyze HC data 515 stored in data repository 520 to determine whetherHC providers 110 (e.g., physicians) have engaged in rewardableactivities (e.g., provided effective treatment regimens to patients 115)and/or achieved positive health outcomes for patients.

In some embodiments where health care credit awarders 530 are insurancecompanies, they may read and analyze HC data 515 stored in datarepository 520 to determine which treatments and regimens producebeneficial results for patients, and which do not, or are less effectivethan others. This information, in turn, may inform policy coveragedecisions by an insurer. For example, an insurer may remove coverage(i.e., not reimburse) for a drug that is not working, according to theinformation in HC data 515, or an insurer may refuse to coverimplantation of a certain, more-expensive brand of pacemaker, if thatpacemaker does not achieve results superior to a less expensive brand,according to the information in HC data 515.

In the embodiment shown, a HC derivate administrator 540 is alsoconnected to, and may access, the data in data repository 520. Invarious embodiments, HC derivate administrator 540 may create, issue,administer, sell, and/or buy HC derivatives whose performance and valueare based on underlying HC data 515. As noted above, HC derivatives maybe embodied as securities or contracts that track health care outcomes.In an investment sense, HC derivatives provide a far more granular andprecise way to invest in and trade on differentiated health caredevices, medications, treatments, techniques, etc., in comparison tohealth care stocks. HC derivatives also provide the opportunity forbrokerages and investment houses to create futures and options tradesbased on underlying health care devices, medications, treatments,techniques, etc.; i.e., futures and options based on the predicted valueof a HC derivative.

In the embodiment shown, HC derivative administrator 540 has created andis managing four exemplary derivatives 551-554. HC derivatives 551-554may be designed and implemented to achieve almost any financialobjective based on underlying health care information. In general, HCderivatives may be designed and implemented to provide a profit orpayout if specific health-related characteristics and events, asindicated by the underlying HC data 515, turn out to be the way theissuer expects (e.g., move in a given direction, stay in or out of aspecified range, reach a certain level or goal, etc.).

For example, HC derivative 551 may be designed to provide leveragerelated to the market penetration of a specific stent, such that a smallmarket penetration as tracked and indicated by the underlying HC data515 (e.g., 2% of all stents used will be ACME Corp. model 123A stents 18months from now), will cause a large difference in the value of HCderivative 551 (e.g., derivative 551 will pay 30 times its issue pricein 18 months if the market penetration goal is reached; and otherwise itwill be worthless).

For another example, HC derivative 552 may track the efficacy of a newcholesterol lowering drug in African American males, as documented andindicated by the underlying HC data 515, and provide a payout such that,after 12 months of usage, if the new drug lowers overall cholesterol anaverage of 0-10% in the African American male demographic group, then HCderivative 552 pays nothing; if the new drug lowers overall cholesterolan average of 10.1-25%, then derivative 552 pays 1.5 times its purchaseprice; if the new drug lowers overall cholesterol an average of25.1-50%, then derivative 552 pays 2.5 times its purchase price; and ifthe new drug lowers overall cholesterol an average of 50.1% or more,then HC derivative 552 pays 4 times its purchase price.

For another example, HC derivative 553 may be designed to track theefficacy of two specific brands of pacemakers relative to each other, asindicated by the underlying HC data 515, such that, after 24 months ofusage, if Brand A pacemakers have required fewer repairs, adjustments,and replacements than Brand B pacemakers, then the derivative pays threetimes its purchase price, and otherwise, it pays nothing.

For yet another example, HC derivative 554 may be designed to track theefficacy of a specific oncology drug in a specific age demographicrelative to another age demographic, as indicated by the underlying HCdata 515, such that, after 24 months of treatment with the oncologydrug, if the remission rate for patients 25 years old and younger is0-15% higher than the remission rate for patients older than 25 years,then the derivative pays nothing; and if the remission rate for patients25 years old and younger is 15.1% or more higher than the remission ratefor patients older than 25 years, then the derivative three pays timesits purchase price.

One of ordinary skill in the art will recognize that system 500 depictedin FIG. 5 is an exemplary, generalized illustration and that componentsand features may be added to, removed from, or modified within system500 without departing from the principles of the invention. For example,one of ordinary skill will recognize that the examples of HC derivatives551-554 are illustrative only, and many other health care derivativesare possible within the scope of the invention, including health carederivatives whose payouts are expressed in terms other than as amultiple of the purchase price. For another example, system 500 may bemodified so that third parties (not shown), including additional HCderivative creators and insurance companies, may be connected to datarepository 520 and allowed to access, mine, and analyze HC data 515 forvarious purposes, including creating additional HC derivatives andshaping health insurance coverages.

FIG. 6 is a flowchart of an exemplary process 600 for managing aderivative security related to health care and/or health care credits,consistent with the principles of the invention. In some embodiments,process 600 may be implemented using a computing system by an entitythat is creating and/or managing derivatives that are based on healthcare treatment and outcome data, such as HC derivative administrator540, as shown in FIG. 5. In the embodiment shown in FIG. 6, process 600begins with creating a derivative security having a value that isdependent upon achieving or fulfilling a specified result or conditionas indicated by health care data (stage 610). For example, as notedabove with respect to FIG. 5, HC derivatives (such as HC derivatives551-554) may be created such that they increase or decrease in value, orpay out a specified amount, if specific health-related characteristicsand events, as indicated by the underlying HC data 515, turn out to bethe way the derivative creator expects (e.g., move in a given direction,stay in or out of a specified range, reach a certain level, etc.). Inother words, the value of a HC derivative may be tied to a condition(s)that is discernable from health care data and HCC flow data that isgenerated and collected incidental to providing health care services toindividuals and/or tied to whether/how that condition(s) is fulfilled orachieved. In various embodiments, creating the derivative may includespecifying a definite time(s) for achieving the specified result(s) andspecifying a definite payout(s) if the specified result(s) are achievedat the specified time(s).

At stage 620, process 600 issues the derivative security to aninvestor(s). In some embodiments, this stage may be implemented byselling or trading the HC derivative security either on a regulatedexchange, such as the Chicago Board of Trade, on a custom HC exchange,such as HC 340 of FIG. 3, or off the exchanges, directly between thedifferent counterparties.

Next, process 600 collects data regarding the specified health careresult that underlies the derivative (stage 630). In variousembodiments, the data collection of stage 630 may be ongoing over thelife of the derivative, as new health care data regarding relevanttreatments, outcomes, etc. is generated by patients and health careproviders over time. In some embodiments, stage 640 may be implementedby retrieving data from data repository 520, as shown in FIG. 5.

At stage 640, process 600 adjusts the value of the derivative securityaccording to the data collected in stage 640 and then ends. Forderivatives that feature a final payout at a specified ending date, thisstage may involve analyzing the health care data collected in stage 630as of the final payout date and determining whether, or which, payoutconditions were met. For example, consider again the example of HCderivative 551 discussed above with respect to FIG. 5, wherein thederivative was created to pay 30 times its issue price if 2% of allstents used are ACME Corp. model 123A stents during a period ending 18months after creation of HC derivative 551. In this example, stage 640involves accessing and analyzing HC data 515 to determine the totalnumber of stents employed during the relevant 18 month period and thenumber of ACME Corp. model 123A stents among that total. Then, stage 640calculates whether the number of model 123A stents is equal to orgreater than 2% of the total, and if so, adjusts the values of HCderivative 551 to be 30 times its issue price. Or, if the calculationshows the number of model 123A stents is less than 2% of the total, thenstage 640 adjusts the value of HC derivative 551 to be zero.

In various embodiments, stage 640 may also include calculating andadjusting the current value of a derivative at a time before the finalpayout date, using either a formula based on the progress to date towardthe specified payout goal(s), or by letting the market set the valueaccording to the bids and offers from buyers wishing to purchase thederivative. Other ways of adjusting the value are also possible, withinthe scope of the invention.

One of ordinary skill in the art will recognize that process 600depicted in FIG. 6 is an exemplary, generalized illustration and thatstages and features may be added to, removed from, or modified withinprocess 600 without departing from the principles of the invention. Forexample, a stage may be added to process 600 wherein the adjusted valueof the derivative security is paid to holders of the derivative, as ofthe final payout date.

Health Care Credit Flows Derivatives

As explained in the related applications, which are incorporated byreference, in various embodiments, HCCs are transferable between a widerange of entities. Although HCCs may be created and awarded by differentcreating entities (e.g., by different insurance companies), in variousembodiments, each creating entity honors HCCs created by anothercreating entity and/or the HCCs of different creating entities may beexchanged for each other, or bought and sold with cash, on exchanges orother marketplaces.

FIG. 7 is a block diagram showing an exemplary system 700 fortransferring and exchanging health care credits, consistent with theprinciples of the invention. In the embodiment shown, HCC account A 705contains HCC credits. HCC account A 705 may be, for example, a healthcare provider HCC account 133, a patient HCC account 136, or anindividual HCC account 143 or 146.

The entity controlling HCC account A 705, such as an individual who hasbeen awarded HCCs from his health insurer for achieving positive healthoutcomes, may freely transfer the HCCs to other entities in the HCCsystem 700. For example, an individual may transfer 781 HCCs from HCCaccount A 705 to a health insurance company A 710 in exchange for areduction in the premium paid by the individual for health insurance.

Similarly, the individual may transfer 784 HCCs from HCC account A 705to a merchant A 730 in exchange for goods and/or services provided bymerchant A 730. In some embodiments, merchant A 730 may have contractedwith health insurance company A 710 (or other entity creating or backingHCCs) to accept HCCs from customers in lieu of cash, with thearrangement that health insurance company A 710 will compensate merchantA 730 with cash for the accepted HCCs. In other embodiments, merchant A730 may have no contract with health insurance company A 710, and maysimply sell received HCCs for cash in a market such as HCC exchange 340as described above with respect to FIG. 3. Other arrangements may alsobe used.

The controlling individual may also transfer 782 HCCs from HCC account A705 to a brokerage account A 720, and then sell them for cash frombrokerage account A 720 on a market such as HCC exchange 340 asdescribed above with respect to FIG. 3.

As also shown in the embodiment of FIG. 7, the controlling individualmay also directly transfer 783 HCCs from HCC account A 705 to an HCCaccount B 740, which may be, for example, a health care provider HCCaccount 133, a patient HCC account 136, or an individual HCC account 143or 146. For instance, the controlling individual may transfer 783 HCCsas a gift to an account belonging to a family member.

As represented by the pathways 781, 782, 783, and 784 emanating from HCCaccount B 740, the entity controlling HCC account B 740 may similarlyexchange, sell, or transfer the credits in the account for a variety ofpurposes. Thus, in various embodiments, HCCs are freely transferableamong the accounts and entities of HCC system 700.

One of ordinary skill in the art will recognize that system 700 depictedin FIG. 7 is an exemplary, generalized illustration and that componentsand features may be added to, removed from, or modified within system700 without departing from the principles of the invention. For example,one of ordinary skill will recognize that any number of merchants,insurance companies, brokerage accounts, individual accounts, exchanges,etc. may be added to system 700 without departing from the principles ofthe invention.

As exhibited by system 700, embodiments that report and store HCCaccount data may track the flow of HCCs throughout system 700, as eachaccount records HCC transfers into and out of the account. And, theremay be useful meanings attributed to each HCC transfer or flow. Forexample, HCC flows into certain accounts may indicate healthy peopleearning credits, HCC flows out of certain accounts may indicate peoplewho require little health care are selling credits or exchanging creditsfor good and services, HCC flows into and out of other specific accountsmay indicate unhealthy people buying credits and using them forhealthcare services, etc.

Moreover, information regarding flow trends and quantities of HCCs beingtransferred to and/or from certain entities, such as to specific vendors(e.g., American Airlines or Wal-Mart), may be significant to investorswho wish to make investments based on anticipated effects, or thepredictive qualities, of the HCC flows.

FIG. 8 is a flowchart of an exemplary process 800 for managing aderivative security related to health care credits consistent with theprinciples of the invention, and in particular a derivative related tothe flow of credits from and to various entities. In variousembodiments, process 600 may be implemented using a computing system byan entity that is creating and/or managing derivatives that are based onhealth care treatment and outcome data, such as HC derivativeadministrator 540, as shown in FIG. 5.

In the embodiment shown in FIG. 8, process 800 begins with creating aderivative security having a value that is dependent upon a specifiedamount of health care credits flowing to a specified entity (stage 810).For example, HC derivatives (similar to HC derivatives 551-554 of FIG.5) may be created that increase in value, or pay out a specified amount,if a specified amount of HCCs flow into/out of the account(s) of aspecified entity(ies), as indicated by the underlying HC data 515. Invarious embodiments, creating the derivative may include specifying adefinite time(s) for achieving the specified amount(s) flowing to thespecified entity(ies) or account(s), and specifying a definite payout(s)if the specified amount(s) are achieved at the specified time(s).

At stage 820, process 800 issues the derivative security to aninvestor(s). In some embodiments, this stage may be implemented byselling or trading the HC derivative security either on a regulatedexchange, such as the Chicago Board of Trade, on a custom HC exchange,such as HC 340 of FIG. 3, or off the exchanges, directly between thedifferent counterparties.

Next, process 800 collects data regarding the amount of HCCs that havebeen received (or transmitted) by the specified entity(ies), which arethe HCC flow(s) that underlies the derivative (stage 830). In variousembodiments, the data collection of stage 830 may be ongoing over thelife of the derivative, as new HCC flow data 565 is generated by accountproviders 560 over time. As shown in FIG. 5, process 800 may collect therelevant data by accessing data repository 520, which stores the HCCflow data 565 placed there by account providers 560.

At stage 840, process 800 adjusts the value of the derivative securityaccording to the data collected in stage 840 and then ends. For HCC flowderivatives that feature a final payout at a specified ending date, thisstage may involve analyzing the HCC flow data 565 collected in stage 830as of the final payout date and determining whether or which payoutconditions were met, in a manner similar to that described with respectto stage 640 of FIG. 6. For example, the value of a HCC flow derivativemay be tied to a condition(s) that is discernable from health care dataand HCC flow data that is generated and collected incidental toproviding health care services and HCC transaction services toindividuals and/or tied to whether/how that condition(s) is fulfilled orachieved. In various embodiments, stage 840 may also include calculatingand adjusting the current value of a HCC flow derivative before thefinal payout date, using either a formula based on the progress to datetoward the specified payout goal(s), or by letting the market set thevalue according to the bids and offers from buyers wishing to purchasethe derivative.

One of ordinary skill in the art will recognize that process 800depicted in FIG. 8 is an exemplary, generalized illustration and thatstages and features may be added to, removed from, or modified withinprocess 800 without departing from the principles of the invention. Forexample, a stage may be added to process 800 wherein the adjusted valueof the derivative security is paid to holders of the derivative, as ofthe final payout date.

HCC Computing Systems

FIG. 9 is a block diagram illustrating an exemplary computing system 900suitable for implementing embodiments consistent with the principles ofthe invention. Other components and/or arrangements may also be used. Invarious embodiments, computing system 900, or several communicativelyconnected instances of computing system 900, may be used to implementprocesses 200, 400, 600, 800, 1200, 1500, 1600, 1700, and 1800, as wellas HCC accounts, HCC exchange 340, and/or HC derivative administrator540, among other things.

Computing system 900 includes a number of components, such as a centralprocessing unit (CPU) 905, a memory 910, an input/output (I/O) device(s)925, and a nonvolatile storage device 920. System 900 can be implementedin various ways. For example, an implementation as an integratedplatform (such as a workstation, server, personal computer, laptop,smartphone, etc.) may comprise CPU 905, memory 910, nonvolatile storage920, and I/O devices 925. In such a configuration, components 905, 910,920, and 925 may connect and communicate through a local data bus andmay access a database 930 (implemented, for example, as a separatedatabase system) via an external I/O connection. I/O component(s) 925may connect to external devices through a direct communication link(e.g., a hardwired or local wifi connection), through a network, such asa local area network (LAN) or a wide area network (WAN), and/or throughother suitable connections. System 900 may be standalone or it may be asubsystem of a larger system.

CPU 905 may be one or more known processing devices, such as amicroprocessor from the Core™ 2 family manufactured by the Intel™Corporation of Santa Clara, Calif. Memory 910 may be one or more faststorage devices configured to store instructions and information used byCPU 905 to perform certain functions, methods, and processes related toembodiments of the present invention. Storage 920 may be a volatile ornon-volatile, magnetic, semiconductor, tape, optical, or other type ofstorage device or computer-readable medium, including devices such asCDs and DVDs, meant for long-term storage.

In the illustrated embodiment, memory 910 contains one or more programsor subprograms 915 loaded from storage 920 or from a remote system (notshown) that, when executed by CPU 905, perform various operations,procedures, processes, or methods consistent with the present invention.Alternatively, CPU 905 may execute one or more programs located remotelyfrom system 900. For example, system 900 may access one or more remoteprograms via network 935 that, when executed, perform functions andprocesses related to embodiments of the present invention.

In one embodiment, memory 910 may include a program(s) 915 thatimplements processes 200 and/or 400, processes 600 and/or 800 and/orprocesses 1200, 1500, 1600, 1700, and 1800. In some embodiments, memory910 may also include other programs or applications that implement othermethods and processes that provide ancillary functionality to theinvention. For example, memory 910 may include programs that gather,organize, store, and/or provide access to health care related data, suchas HC data 515, HCC flow data 565, HCC account data, data indicative ofa health metric or a behavior affecting health, etc.

Memory 910 may be also be configured with other programs (not shown)unrelated to the invention and/or an operating system (not shown) thatperforms several functions well known in the art when executed by CPU905. By way of example, the operating system may be Microsoft Windows™,Unix™, Linux™, an Apple Computers™ operating system, Personal DigitalAssistant operating system such as Microsoft CE™, or other operatingsystem. The choice of operating system, and even to the use of anoperating system, is not critical to the invention.

I/O device(s) 925 may comprise one or more input/output devices thatallow data to be received and/or transmitted by system 900. For example,I/O device 925 may include one or more input devices, such as akeyboard, touch screen, mouse, and the like, that enable data to beinput from an administrative user, such as a system operator, or anapplication user. Further, I/O device 525 may include one or more outputdevices, such as a display screen, CRT monitor, LCD monitor, plasmadisplay, printer, speaker devices, and the like, that enable data to beoutput or presented to a user. I/O device 925 may also include one ormore digital and/or analog communication input/output devices that allowcomputing system 900 to communicate, for example, digitally, with othermachines and devices, including client devices (e.g. users' desktop orlaptop computers). Other configurations and/or numbers of input and/oroutput devices may be incorporated in I/O device 925.

In the embodiment shown, system 900 is connected to a network 935 (suchas the Internet, a private network, a virtual private network, or othernetwork), which may in turn be connected to various systems andcomputing machines (not shown), such as personal computers, laptopcomputers, servers, and/or smartphones of users, such as users 310,1005, or 1905. In general, system 900 may input data from externalmachines and devices and output data to external machines and devicesvia network 935.

In the exemplary embodiment shown in FIG. 9, database 930 is astandalone database external to system 900. In other embodiments,database 930 may be hosted by system 900. In various embodiments,database 930 may manage and store data used to implement systems andmethods consistent with the invention. For example, database 930 maymanage and store data structures that contain data such as HC data 515,HCC flow data 565, data indicative of a health metric or a behavioraffecting health, and/or cost information associated with health-relatedmetrics, behaviors, and activities, etc.

Database 930 may comprise one or more databases that store informationand are accessed and/or managed through system 900. By way of example,database 930 may be an Oracle™ database, a Sybase™ database, or otherrelational database. Systems and methods consistent with the invention,however, are not limited to separate data structures or databases, oreven to the use of a database or data structure.

The preceding description of a computing system is exemplary and notmeant to be limiting. In one or more exemplary implementations, thefunctions and processes described may be implemented in hardware,software, firmware, or any combination thereof. If implemented insoftware, the functions may be stored as instructions or code on acomputer-readable medium. Computer-readable media includes both computerstorage media and communication media including any medium thatfacilitates transfer of a computer program from one place to another. Astorage media may be any available non-transitory media that can beaccessed by a computer. By way of example, and not limitation, suchcomputer-readable media can comprise RAM, ROM, EEPROM, CD-ROM or otheroptical disk storage, magnetic disk storage or other magnetic storagedevices, or any other medium that can be used to hold desired programcode in the form of instructions or data structures and that can beaccessed by a computer. Also, any remote device may be properly termed acomputer-readable medium. Combinations of the elements described hereincan also be included within the scope of computer-readable media.

FIG. 10 is a block diagram of an exemplary health care credit andexchange system 1000, consistent with the principles of the invention.In various embodiments, for example as shown in FIG. 10, system 1000enables earned incentives in one health plan to be conveyed ortransferred to a person in another health plan and then used to pay formedical care and the like. System 1000 also allows use of HCCs, whichrepresent a conveyable or transferable form of value, to pay for, or beexchanged for, health services (e.g., medical care and the like)independent of an individual's affiliation or non-affiliation with aparticular health plan.

As shown in the example of FIG. 10, a first user 1005 may have an amountof points or credits or the like that were awarded to the first user1005 by a health insurance plan, or the like, to which the first user1005 belongs. In various embodiments, the HCCs may have been provided tothe first user 1005 as an incentive or reward for performinghealth-benefiting behaviors. Using a health care credits exchangenetwork 1010, the first user 1005 may transfer or convey all or aportion of their points or credits to a second user 1015, who may or maynot belong to the same health insurance plan as the first user 1005.

As shown in this embodiment, the health care credits exchange network1010 may include a health care credit exchange 1020, as describedpreviously in this specification and the incorporated-by-referenceapplications, which acts as one example of a means to transfer HCCs fromone party to another. In addition, various embodiments of the healthcare credits exchange network 1010 may include means for converting thepoints or credits issued by a health plan into HCCs, which may beimplemented as transferable units of value, like a currency, and may behandled and processed by the HCC exchange 1020.

In various embodiments, the health care credits exchange network 1010and/or the HCC exchange 1020 may be established by participating healthplans (e.g., health insurance companies) and health-care relatedentities (e.g., health care providers, such as hospitals, labs, andphysician groups). In general, health care credits exchange network 1010may include processes and devices that enable creation and/or issuanceof HCCs, monitoring, management, transferral, and conveyance of HCCs,creation, monitoring, and management of securities and/or derivativesthat relate to HCCs, monitoring and management of the health-relatedbehaviors and incentives underlying the HCCs, monitoring and managementof the activities and data that underlie the incentives themselves, andthe like, as described throughout this specification and theincorporated-by-reference applications.

As noted previously, the HCC exchange 1020 is not necessarily involvedin all transfers of HCCs from the first user 1005 to the second user1015, as the first user 1005 may transfer HCCs as a gift or as part of abarter or other transfer arrangement with the second user 1015. Asdescribed herein, the HCC Exchange 1020 may issue HCCs and transfer orconvey HCCs, in some instances via associated brokers or third-partyentities that trade for individuals or institutions for a commission. Insome embodiments, the HCC Exchange 1020 may be responsible for settingtrading rules, rules for brokerage commissions, reporting rules,self-reporting, and self-governance guidelines for its members. In someembodiments, the HCC Exchange 1020 may function in compatibility withmechanisms of the Chicago Commodities Exchange, NASDAQ stock exchange,or other similar entities.

FIG. 11 is a block diagram of a subsystem 1100 of an exemplary healthcare credit and exchange system, such as system 1000, consistent withthe principles of the invention. In the exemplary embodiment shown inFIG. 11, subsystem 1100 includes a conversion process 1110 that createsHCCs by converting incentive points belonging to the user 1005 (e.g.,earned by the user 1005) into HCCs that may be initially stored andmanaged in a health care credits account 1115. From the health carecredits account 1115, the HCCs may be sold, conveyed, exchanged,transferred, etc. to other parties as described throughout thisspecification and the incorporated-by-reference applications.

FIG. 11 also illustrates an HCC issuer 1120, such as a health insurancecompany, private philanthropic organization, or government entity, thatmay create, issue, or transfer HCCs, for example into health carecredits account 1115, and back or support the initial value of the HCCsthat it creates, so that the HCCs can be used like a form of currencyfor health care, or used for other purposes, or saved in an HCC account.

In some embodiments wherein HCCs do not originate via converting earnedincentive points using conversion process 1110, but instead come intothe health care credits account 1115 from the HCC issuer 1120, the HCCsmay be purchased beforehand by the HCC issuer 1120, for example on anHCC Exchange 340 as explained with respect to FIG. 3. The value ofpurchased HCCs may be a market value set by the HCC Exchange 340according to supply, demand, ask price, bid price, and other factors, asin stock and commodity exchanges. In various embodiments, HCCs may bethought of as a securitized or monetized form of incentive points, whichoriginally have value but not liquidity. Converted into the form ofHCCs, the health incentive points can become liquid, so they can befreely transferred, traded, speculated on, etc., unlike incentivepoints, and their market value can go up or down, depending on what aseller and buyer consider them to be worth, and on what they eventuallyagree on to be the price. In some embodiments, HCCs may have propertiesof securities, though they may not necessarily or technically beimplemented in the form of an actual security.

As noted with respect to FIG. 10, in various embodiments, the HCCs maybe a recognized and accepted sort of transferable or conveyable currencyfor health-related services and products, utilized by at least some ofthe participants or members of an HCC exchange network 1010. In someembodiments, a government, regulating body, or other entity may requirethat health care providers and health insurers participate in the HCCexchange network 1010, such that at least two different health insuranceplans and their associated/participating health care providers (e.g.,physicians) accept the HCCs as a form of currency or value for servicesand products, including health-related services and products.

FIG. 12. is an exemplary process 1200 for converting non-transferableincentive points or credits earned in a health care plan into freelytransferable HCCs, consistent with embodiments of the invention. In someembodiments, process 1200 may be used to implement conversion process1110 of FIG. 11. In various embodiments, process 1200 may convertdiversely valued, non-liquid incentive points or credits into moreuniformly valued HCCs that can be freely conveyed, transferred, bought,sold, etc. In various embodiments, process 1200 may be implemented by asoftware program or application executed by a computing system, and thecomputing system may be part of a HCC brokerage, HCC exchange, etc.

In the embodiment shown, process 1200 begins with receiving informationspecifying an amount of incentive points awarded for health-relatedbehavior. In various embodiments, an amount of earned incentive pointsassociated with an individual in a particular health plan may becollected or managed in an electronic account for that individual thatis provided by the plan. In some embodiments, the account may beattached to or associated with the individual's electronic healthrecords or personal health record, while in other embodiments, theaccount may be an independent account. In various embodiments, theaccount may allow the account owner to indicate that he or she wouldlike to convert those incentive points or credits into HCCs that can beconveyed or transferred outside of the plan. For example, theinformation received by stage 1205 may come from an individual, such asuser 1005, who has 100 Kaiser Permanente™ incentive points that wereearned or awarded for following a post-operative exercise andrehabilitation regimen, where within the Kaiser Permanente™ plan, the100 incentive points may be worth $100.

At stage 1215, process 1200 determines a par value for thehealth-related behavior associated with the points. In variousembodiments, the par value is created to represent an initial statedvalue of the incentive points, which may be a starting point for themarket-determined value of the HCCs that result from conversion of theincentive points. The type and value of incentive points offered andearned in various insurance plans and/or offered by various employersmay be broad and diverse, such that the incentive point values, and thecorresponding dollar values, for the same health-related behavior willdiffer from plan to plan, from employer to employer, etc., and the parvalue is one means for normalizing or making more uniform these diversevalues.

As noted previously, there may be many reasons for disparity between thetype and value of incentive points awarded by various health careorganizations, health insurance companies, and the like, in relation tothe same activities and behaviors. In some instances, a company mayaward more incentive points than another company for a given activitybecause it has data or statistics indicating value associated with thatactivity, which, e.g., translates into avoidance of cost to the company,where the other company does not have, or has not recognized, the dataor value. In such instances, the health care organization or company maymarket their plans and services to particular groups of individuals whoare most likely to perform the given behavior, procedure, activity orregimen, using the incentive disparity as a marketing tool. For example,insurance company A may use a marketing tagline such as “Company A gives50% more incentive points for activity Y that Company B, so sign up withus today for your health care insurance coverage,” or the like.

In various embodiments, stage 1215 may be implemented by an electroniccomputing system that calculates the par value based on a previouslyestablished value(s) of the underlying health-related behavior oractions which led to the incentive points. In some embodiments, stage1215 may determine a par value based on the value of the health-relatedbehavior in at least one, and in various embodiments two or more, othersources of health care cost data, such as health plans. For instance,continuing the example of 100 Kaiser Permanente™ incentive points thatwere earned or awarded for following a post-operative exercise andrehabilitation regimen, the value of that regimen may be compared withthe value of that regimen as determined by at least two other recognizedsources. In some embodiments, the sources may be other health plans,etc. (including government-sponsored health plans) that are participantsin the health care credits exchange network 1010. Thus, the value of theregimen as determined by ConnectiCare™ and Humana™ may be used todetermine a par value for the Kaiser Permanente™ point—e.g., if thevalue of the regimen in ConnectiCare™ is $90, and the value in Humana™is $110, then an average calculation (($90+$110)/2) may be used todetermine the par value of the Kaiser Permanente™ points at $100. Inother embodiments, a different calculation, such as a mediancalculation, a weighted average, or the like, may be used to calculate apar value. In various embodiments, information regarding the values ofvarious health care behaviors, regimens, procedures, etc. may be storedin an electronic database maintained by the health care credits exchangenetwork 1010.

In other embodiments of stage 1215, par value may be determined usingthe value of the health-related behavior set by a source that isconsidered a standard, such as a government-sponsored health plan, orset by some other recognized standard source. For example Medicare maybe used as a standard source for a par value calculation, as Medicarehas assigned a monetary value to a wide range of health-relatedbehaviors, including procedures, treatments, activities, etc. such asexercise regimens, dietary choices, self-testing, therapeutictreatments, device treatments, and the like.

In some embodiments, the standard source values (e.g., Medicare values)may be used to assign a standardized par value for the incentive pointsor credits belonging to individuals enrolled in a broad range of healthplans based on the health-related behavior that generated the incentivepoints or credits. For instance, continuing the example of 100 KaiserPermanente™ incentive points that were earned or awarded for following apost-operative exercise and rehabilitation regimen, if the Medicarevalue of the regimen is $80, then process 1200 may assign a par value of$80 to the regimen and to the 100 Kaiser Permanente™ incentive points,regardless of Kaiser Permanente's in-plan value of $100 for the regimenand the 100 Kaiser Permanente™ incentive points. In other embodiments,the par value may be set by a purpose-designed incentive evaluationprogram or function.

In some embodiments the standard source values (e.g., Medicare values)may be used to indirectly derive a standardized par value for ahealth-related behavior not covered by the standard source (and for theassociated incentive points or credits) based on the value of otherhealth-related behaviors in relation to the standard source values. Thisis explained in greater detail below with respect to FIG. 13.

At stage 1220, process 1200 converts the incentive points into HCCsbased on the par value determined in stage 1215. In the embodiment shownin FIG. 12, the HCCs differ from the incentive points or credits atleast because the HCCs are freely transferable and conveyable betweenthe owner and another party regardless of health plan membership, unlikeincentive points, and because the monetary value of the HCCs outside ofthe originating plan, (as reflected in the par value) may differ fromthe monetary value of the incentive points inside the plan as describedabove with respect to stage 1215. In various embodiments, a computingsystem associated with a broker or other participant in health carecredits exchange network 1010 may manage an HCC account that holds theHCCs created in stage 1220. The HCCs may be sold, transferred, etc.,from the HCC account, as described previously in this specification withrespect to FIGS. 1-4 and 7, and in the incorporated-by-referenceapplications. In various embodiments, the open market value of the HCCsmay be determined via a negotiation between the transferor (e.g. seller)and the transferee (e.g., buyer), based on an ask and a bid, and thefinal agreed market price may be set at par, at a premium above par, orat a discount to par.

FIG. 13 illustrates an example of deriving a par value for ahealth-related behavior based on the value of other health-relatedbehaviors in relation to a standard reference, such as Medicare values,consistent with embodiments of the invention. In some embodiments, acalculation as described with respect to FIG. 13 may be performed byprocess 1200. As shown in FIG. 13, table 1300 includes a Behavior column1305, each row of which specifies a health-related behavior or activity,such as undergoing procedure X (column 1305, row 1330), engaging inbehavior Y (column 1305, row 1335), performing activity Z (column 1305,row 1340), performing regimen A (column 1305, row 1345), and undergoingprocedure B (column 1305, row 1350).

Table 1300 also includes a Standard Reference column 1310 that indicatesa standard cost or value associated with the health-related behavior ineach row. In some embodiments, the standard values for eachhealth-related behavior in column 1305 may be a value set by Medicare asthe standard reference source, whereas Medicare has already establishedreimbursement costs for many health-related products, services, andbehaviors. As shown in the cells at the intersection of column 1310 androws 1345 and 1350, some behaviors do not have a standard cost or valueprovided by the Standard Reference source, which is indicated by “NA.”

Table 1300 also includes Company A column 1315 that indicates an amountof incentive points or credits awarded by company A for thehealth-related behavior in each row; Company B column 1320 thatindicates an amount of incentive points or credits awarded by company Bfor the health-related behavior in each row; and Company C column 1325that indicates an amount of incentive points or credits awarded bycompany C for the health-related behavior in each row. In someembodiments, companies A, B, and C may be health insurance companies ororganizations. In various embodiments, the information in table 1300 maybe stored in a data structure accessible by a program or applicationthat computes a par value for a health-related behavior, such as aprogram or application implementing process 1200.

A process, such as process 1200, may use the information in table 1300to determine a par value for a health-related behavior that does nothave a standard reference value (“NA” in column 1310), such as Regimen Ain row 1345 and Procedure B in row 1350, by calculating the value of acompany's point for other standard-reference health behavior(s), andthen multiplying that value by the number of points awarded by thecompany for the health-related behavior that does not have a standardreference value. In various embodiments, the value of a company's pointmay be calculated using an average calculation, a weighted averagecalculation, a median calculation, or some other calculation.

For example, using an average calculation, the average standard valueper point for Company A may be calculated by adding the standardreference costs (column 1310) of health-related behaviors (column 1305)for which table 1300 contains incentive point entries for company A(rows 1330 and 1335 of column 1315) and dividing the result by the sumof the incentive points for company A (the cells of table 1300 at theintersection of row 1330 and column 1315 and at row 1335 of column1315). Thus, for company A, this calculation is:

Average  Standard  Reference  $  per  Co.  A  point = ($100 + $200)/(50  pts.+100  pts) = $300/150  pts = $2/point  for  Company  A.

Similarly for company B, the calculation is:

Average  Standard  Reference  $  per  Co.  B  point = ($100 + $200 + $300)/(200  pts.+380  pts + 550  pts) = $600/1130  pts = $0.53/point  for  Company  B.

A similar calculation for Company C results in an average value of $0.97per point for Company C.

To determine a par value for regimen A (row 1345), which does not have astandard reference value (NA at intersection of column 1310 and row1345), the number of incentive points awarded by Company A for regimen A(150 incentive points, at intersection of column 1315 and row 1345) maybe multiplied by the average standard value per point for Company A ($2per point, calculated above) to yield $300. Similarly, to derive a parvalue for procedure B (row 1350), which does not have a standardreference value (NA at intersection of column 1310 and row 1350), thenumber of incentive points awarded by Company B for regimen A (700incentive points, at intersection of column 1320 and row 1350) may bemultiplied by the average standard value per point for Company B ($0.53per point, calculated above) to yield $371.

As noted above with respect to FIG. 12, these par values may be used toconvert incentive points into a number of HCCs that is equal to the parvalue, based, for example, on the current market price of an HCC. Forexample, if the current market value of an HCC is $1, then the 700Company B incentive points awarded for procedure B (intersection ofcolumn 1320 and row 1350) may be converted into a lot of 371 HCCs, andthe 150 Company A incentive points awarded for regimen A (intersectionof column 1315 and row 1345) may be converted into 300 HCCs.

In addition to par value calculators, other computer programs, such asapps for smart phones, etc. may use the information in table 1300. Forexample, programs or apps that allow individuals with HCC accounts tocalculate the number of credits they need for a given health-careprocedure, to calculate how much their HCCs are worth if they tradethem, to perform the actual trades or exchanges of HCCs, etc. may accessdata such as is shown in table 1300 to perform their functions. In otherareas, social media services, such as Facebook™, Twitter™, etc., mayprovide programs that access data such as is shown in table 1300 andprovide functionality for users to “advertise” their available credits.

FIG. 14 is a block diagram of an exemplary system for transferring HCCsto an individual(s) that is unable to pay for health care products andservices, consistent with embodiments of the invention. In the exemplaryembodiment shown in FIG. 14, an under-insured or uninsured person 1405may use HCCs placed into a HCC account 1415 by an organization 1420 topay for health care products and services provided by a health careprovider 1410.

The health care provider 1410 may be any type of professional or vendorof health-related goods or services, as described throughout thisspecification and the incorporated-by-reference applications, anduninsured person 1405 may convey or transfer HCCs to health careprovider 1410 in exchange for health-related goods or services and inlieu of a cash payment or insurance arrangement. In various embodiments,the transfer of HCCs to health care provider 1410 from HCC account 1415may be implemented electronically over a computer network or phone line,such that the HCCs are credited to an account (not shown) of health careprovider 1410. In such embodiments, health care provider 1410 may be aphysician or other health care provider that accepts HCCs as a form ofpayment for medical care in lieu of cash or insurance. In some suchembodiments, the physician may register with an HCC exchange network andagree to accept HCCs as a form of payment, either alone or together withcash and/or a partial payment from an insurance plan. In some cases, apatient may use HCCs to make up the difference between what is owed bythe patient for health care services and what is paid for by insurance.As explained in more detail in the co-pending applications that havebeen incorporated by reference, a health insurance plan may receive abill from a participating physician, and after any co-payment andco-insurance are applied to the balance, may receive HCCs that arewithdrawn from the patient's HCC account to pay for the remainder of thebill, either in total or together with cash. In some scenarios, thepatient may receive a bill directly from the participating physician,and the patient may determine how many HCCs he or she wishes to use forpayment and initiate transfer of the HCCs to the physician.

The HCC account 1415 may be an electronic account for managing healthcare credits, as described throughout this specification and theincorporated-by-reference applications, and may be established by orfor, and/or under the control of, the uninsured person 1405. In someembodiments, the HCC account 1415 for the uninsured person 1405 may beestablished by the uninsured person 1405. In other embodiments, the HCCaccount 1415 for the uninsured person 1405 may be established by anorganization, such as organization 1420, which may establish HCCaccounts for individuals or groups who do not have health insurance orwho do not have the financial means to pay for adequate medical care,either for themselves or for their families. Accounts such as account1415 do not have to be affiliated with a specific insurance plan or anemployer. They may be independent HCC accounts, similar to bank accountsor securities accounts.

In various embodiments, the organization 1420 may be a party unrelatedto the uninsured person 1405, such as a charitable foundation ororganization, a public or private welfare organization, or aphilanthropic individual. As shown in this example, the organization1420 may have an HCC account 1425 associated with it. In someembodiments, organization 1420 may be a state or federal government, ora government-affiliated organization that is tasked with incentivizinggreater wellness among citizens. In such embodiments, the governmentorganization 1420 may use a computerized system to identify or selectcitizens or individuals within a certain income level (e.g., below thepoverty income level) and designate those citizens (e.g., uninsuredperson 1405) as eligible recipients of HCCs from the government. Thegovernment organization 1420 may supply the eligible recipients withHCCs, which must be used for health care and health-related products andservices.

The government organization 1420 may require the eligible recipients toopen an HCC account, such as HCC account 1415, with an account provider,or may open an HCC account 1415 on behalf of each eligible recipient.The government organization 1420 may deposit HCCs into these accounts,and the eligible recipient owners of the accounts could then use thedeposited HCCs to pay for health-related expenses, such as visits to aphysician or health care provider 1410. The government organization 1420may use the awarding of HCCs as an incentive for the eligible recipientsto engage in health-benefitting behaviors and actions that areadvantageous to the individuals' health.

In the embodiment shown in FIG. 14, the organization 1420 may transmitan electronic communication to an HCC Exchange 1430, via, for example, adigital communications network or a phone line, that includes a bid or arequest to purchase one or more HCCs. Upon receipt, HCC Exchange 1430may log the bid in a computerized trading system and match the bid withat least one “ask” offer to sell one or more HCCs, which was transmittedto HCC Exchange 1430 by a seller associated with HCC seller account1435. If a bid-ask match is made, an amount of money equal to the bidprice is electronically transferred from the account 1425 oforganization 1420 to the account 1435 of the seller, and the purchasedamount of HCCs are electronically transferred from the account 1435 ofthe seller to the account 1425 of organization 1420. The details of theoperation of HCC exchange 1430 are explained throughout thisspecification, including with respect to FIGS. 3 and 4, and theincorporated-by-reference applications. Similarly, HCC exchange 1430 maymatch bids and asks and complete trades, as performed in the stock andcommodity exchange arts.

As noted above, once the purchased HCCs are in the HCC account 1425 oforganization 1420, the organization 1420 may then convey or transfer theHCCs to an individual(s), such as uninsured person 1405, who may thenuse the HCCs to receive health care services and products that would nototherwise be available to them.

FIG. 15 is a flowchart of an exemplary process 1500 for facilitatinghealth care credit transactions, consistent with embodiments of theinvention. In some embodiments, process 1500 may be implemented by acomputing system included in a HCC exchange, such as HCC exchange 340 ofFIG. 3 or HCC exchange 1430 of FIG. 14.

As shown, process 1500 begins with receiving information describing,specifying, or indicating HCCs associated with individuals (stage 1510).In various embodiments, the HCCs may have been previously calculated andawarded to a variety of individuals based on data indicative of theindividuals' health and/or data indicative of behaviors affecting theindividuals' health. In some embodiments, the amount of health carecredits may have been previously calculated and awarded to individualsbased on a cost reduction in health care associated with the metrics orthe behaviors.

In some embodiments, the received information may be digital informationreceived over a digital communication network by a computing system orserver system that operates as part of an HCC exchange, as part of anHCC brokerage firm, or as part of some other organization that maintainsaccounts that hold and manage HCCs for individuals and other entities.In some embodiments, the received information may be transmitted by ahealth care provider, a health insurer, or an individual, among othersources.

At stage 1515, process 1500 associates the HCCs with entities accordingto the received information. For example, each lot of HCCs may beassociated with the individuals that earned, or otherwise own, the HCCs.In various embodiments, a server or other computing system implementingprocess 1500 may associate the HCCs by updating a database containing aprofile or data file for each entity among the entities.

In the embodiment shown, stage 1515 may also assign the HCCs to one (ormore) account associated with each entity according to the informationreceived in the previous stage, such as HCC account, as describedthroughout this specification and the incorporated-by-referenceapplications. In some embodiments, the data files or profiles may bepart of, or linked to, an HCC account.

At stage 1520, process 1500 enables access to the account(s) containingthe HCCs. In various embodiments, access may be enabled over a network,such as digital communications network. For example, an entity, such asan individual that was awarded HCCs, may be able to log into aserver-run web site over the internet using a desktop or laptopcomputer, and control an HCC account using the web site interfaces,similar to the way online banking accounts, online stock accounts,online commodity accounts, etc. are accessed and controlled. In variousembodiments, access to the account may include the ability to performoperations for initiating a sale or trade of health care credits inexchange for currency, reward program points, credits for other goods orservices, etc. In some embodiments, process 1500 may display to anindividual who has access to an account a number of credits earned byand associated with the individual, enable the individual to manipulatea user interface element to select up to all of the number of creditsearned by and/or associated with the individual, and enable theindividual to manipulate a user interface element to transmit a desireto transfer the selected number of health care credits.

At stage 1530, process 1500 receives information indicating a desire orpermission to convey or transfer an interest in one or more HCCs. Forexample, a server or other computing system at a brokerage or HCCexchange may receive sell order information from the owner/user of anHCC account indicating that the owner wishes to sell a specified numberof HCCs from the account on an HCC exchange. For another example, aserver at an HCC account provider, such as a bank or insurance company,may receive transfer order information from the owner of an HCC accountindicating that the owner wishes to transfer a specified number of HCCsfrom their account to another HCC account, such as the account of afamily member or a health care provider.

At stage 1540, process 1500 receives information indicating a desire toreceive the interest in one or more HCCs. For example, a server or othercomputing system at a brokerage or HCC exchange may receive buy orderinformation from the owner/user of an HCC account, indicating that theowner wishes to purchase a specified number of HCCs on an HCC exchange.For another example, a server at an HCC account provider, such as a bankor insurance company, may receive transfer order information from theowner of an HCC account, indicating that the owner wishes to transfer aspecified number of HCCs from their account and including informationindicating the transferee that desires to receive the HCCs, such asinformation specifying the HCC account of the transferee that isreceiving HCCs as a gift.

After receiving the information indicating the desire to convey HCCs andto receive HCCs, process 1500 finishes at stage 1550 by executing atransaction to transfer HCCS from the account associated with theinformation indicating the desire to convey or transfer (e.g., theaccount of the seller or transferor) to the account associated with theinformation indicating the desire to receive (e.g., the account of thebuyer or transferee).

One of ordinary skill in the art will recognize that process 1500depicted in FIG. 15 is an exemplary, generalized illustration and thatstages and features may be added to, removed from, or modified withinprocess 1500 without departing from the principles of the invention. Forexample, a stage may be added to receive an electronic payment from, ormessage indicating payment by, a buyer associated with the secondindication and stage 1550 may be modified to execute the transfer onlyupon receiving the payment. For another example, stages may be added forreceiving a registration for one or more entities, by an operator oradministrator of the server system, and for creating a profile or datafile associated with one or more of the entities based on information inthe registration. For yet another example, stages following theexecution of the transaction may be added for sending to an individualassociated with the first indication a message confirming that thetransaction has completed, and for updating that individual with adisplay of the individual's remaining number of health care credits. Foryet another example, stages may be added for requiring submitters ofsecond indications, such as prospective health care credit buyers, toregister with an operator or administrator of the server system, and tosubmit payment information. For still another example, stages may beadded for adjusting a price that an entity submitting a secondindication must pay for a health care credit based on a comparisonbetween a calculated demand for health care credits and a number ofavailable health care credits.

FIG. 16 is a flowchart of an exemplary process 1600 associated with ahealth care credit program, consistent with embodiments of theinvention. In some embodiments, process 1600 may be implemented by acomputing system, for example, by a computing system provided by aninsurance provider, an account provider, an account servicer, or thelike, as described in this specification and theincorporated-by-reference applications.

As shown, process 1600 begins with receiving data indicative of a metricof an individual's health or a behavior affecting the individual'shealth (stage 1610). In various embodiments, the data indicative of ametric of an individual's health may be data gathered or generated aspart of a health assessment, for example, as described with respect toFIGS. 4 and 5 of incorporated-by-reference application Ser. No.13/273,430 and Ser. No. 13/273,366. In various embodiments, the data maybe received over a network, such as the Internet. Examples of metrics ofan individual's health include the individual's weight, body mass index,blood pressure, cholesterol levels, current illnesses or diseases, andthe like. Another example is a baseline health level of the individual.Similarly, in various embodiments, the data indicative of a behavioraffecting the individual's health may be data gathered or generated aspart of a health assessment, for example, as described with respect toFIGS. 4 and 5 of incorporated by reference application Ser. No.13/273,430 and Ser. No. 13/273,366. Examples of behaviors affecting theindividual's health include exercising, taking of medication, submittingto medical examination, eating healthy foods, reducing calorie intake,reducing body weight, reducing body mass index, having a diagnosticexam, receiving a medical treatment, using a medical device, and ceasingsmoking, and the like.

At stage 1615, process 1600 calculates, using the data received in theprevious stage, an amount of health care credits to award to theindividual, according to the metric or behavior. In various embodiments,stage 1615 may calculate the amount by determining a predicted,estimated, or actual health-care cost savings or reduction associatedwith the metric or behavior (e.g., a dollar amount of savings) andconverting the predicted or actual health-care cost savings into anamount of HCCs or, in some embodiments, incentive points. For example,if an individual reduces their body mass index to within preferredmedical guideline limits, then there may be, for example, a predicted,estimated, or historical health-care cost savings of $300 per yearassociated with this metric, and according to the individual's healthinsurance plan, $300 may be considered to be worth 300 incentive pointsor an amount of 300 HCCs. For another example, if an individual followsa cholesterol care regimen, including taking statin medication daily,then there may be a predicted health-care cost savings of $100 per yearassociated with this behavior, and the individual's health insuranceplan may set the conversion rate of dollars to incentive points or HCCsat 2 to 1, such that the $100 may be converted to 50 incentive points oran amount of 50 HCCs.

In some embodiments, the predicted or actual health-care cost savings orreduction associated with the metric or behavior may be retrieved from adatabase or data store indexed and searchable by metric or behavior,where the dollar amounts are derived from clinical trials, medicalstudies, empirical statistical evidence gathered by insurance companiesreflecting the histories of insureds, or other similar sources. In someembodiments, stage 1615 may calculate the HCC amount after adjusting abaseline health-care cost savings (for example, as retrieved from adatabase) to reflect the individual's personal characteristics, such asrace, age, height, weight, family history, previous treatments, etc.

In some embodiments, the received data may be a metric that indicates aninitial or current health level of the individual, and a predicted orestimated health-care cost savings or reduction associated with themetric may be calculated by comparing the initial health level to abaseline health level for a population having characteristics similar tocharacteristics of the individual and estimating or assigning an amountto the cost reduction based on a difference between the initial healthlevel and the baseline health level.

In some embodiments, the received data may include a metric reflecting ameasurement of an initial health level for the individual, and a metricreflecting a measurement of a subsequent health level for theindividual, and calculating the health care credit amount may includeestimating or assigning a value to the health care credit amount basedon a difference between the initial health level and the subsequenthealth level.

In some embodiments, stage 1615 may determine medical care that will be,or is predicted to be, avoided by the individual because the individualperforms the behavior affecting the individual's health as indicated inthe received data, and may estimate or assign a value for the healthcare credit amount based on a cost of the avoided medical care. Invarious embodiments, all or a portion or a fraction of the cost of theavoided medical care may be used to calculate the amount of HCCs toaward. Examples of avoided medical care include a health care protocol,a health care regimen, a diagnostic test, a health care procedure, and ahealth care treatment, among others.

At stage 1620, process 1600 associates one or more health care creditswith the individual, where the one or more HCCs correspond to the amountof HCCs or incentive points calculated in the previous stage. In theembodiment shown, the HCCs are associated with the individual byupdating a profile or data file associated with the individual. Invarious embodiments, the profile or data file may correspond to, beassociated with, or be part of an HCC account, such as HCC account 136,143, 146, 310-325, or 360-375, or the like.

At stage 1630, process 1600 enables the individual to receive valueassociated with the one or more health care credits by enabling theindividual to access an account containing the one or more health carecredits. As just noted, in various embodiments, the account may be anHCC account, such as HCC account 136, 143, 146, 310-325, or 360-375, asdescribed throughout this specification and theincorporated-by-reference applications.

In various embodiments, the individual may access the account to performactions transferring the HCCs contained in the account like a form ofcurrency, either in exchange for something of value (e.g., cash,products, insurance, or services) or as a gift, as described, forexample, with respect to FIGS. 2, 3, 4, and 7. In the embodiment shown,HCCs contained in HCC accounts may act like, and/or may be consideredtransferable financial instruments, similar to cash, bearer bonds, etc.

One of ordinary skill in the art will recognize that process 1600depicted in FIG. 16 is an exemplary, generalized illustration, and thatstages and features may be added to, removed from, or modified withinprocess 1600 without departing from the principles of the invention. Forexample, stages may be added to embody the one or more HCCs in aphysical financial instrument, and to transfer or deliver the physicalfinancial instrument to the individual. For another example, a stage maybe added to enable the transfer of the one or more health care creditsto a health care provider, either in electronic form (e.g., from HCCaccount to HCC account) or in physical form (e.g., in implementationswhere the HCC is embodied as a physical financial instrument). In somesuch embodiments, the HCC may be transferred to the health care provideras a reward or compensation for providing health care services orproducts to the individual, including providing information or directionto the individual regarding the individual's health or the behavioraffecting the individual's health.

FIG. 17 is a flowchart of an exemplary process 1700 associated with ahealth care credit program, consistent with embodiments of theinvention. In some embodiments, process 1700 may be implemented by acomputing system, for example, by a computing system provided by aninsurance provider, an account provider, an account servicer, or thelike, as described in this specification and theincorporated-by-reference applications.

As shown, process 1700 begins with receiving data indicative of a metricof an individual's health or a behavior affecting the individual'shealth (stage 1710). In various embodiments, the data indicative of ametric of an individual's health may be data gathered or generated aspart of a health assessment, for example, as described with respect toFIGS. 4 and 5 of incorporated by reference application Ser. No.13/273,430 and Ser. No. 13/273,366. The data may be received over adigital communications network in various embodiments. Examples ofmetrics of an individual's health include the individual's weight, bodymass index, blood pressure, cholesterol levels, current illnesses ordiseases, and the like. Another example is a baseline health level.Similarly, in various embodiments, the data indicative of a behavioraffecting the individual's health may be data gathered or generated aspart of a health assessment, for example, as described with respect toFIGS. 4 and 5 of incorporated by reference application Ser. No.13/273,430 and Ser. No. 13/273,366. Examples of behaviors affecting theindividual's health include exercising, taking of medication, submittingto medical examination, eating healthy foods, reducing calorie intake,reducing body weight, reducing body mass index, having a diagnosticexam, receiving a medical treatment, using a medical device, ceasingsmoking, and the like.

At stage 1715, process 1700 processes the data received in the previousstage to calculate an amount of health care credits to award to theindividual, based on the metric or behavior. In various embodiments,stage 1715 may be implemented in a manner similar to the embodimentsdescribed above with respect to stage 1615 of FIG. 16. For example, invarious embodiments, stage 1715 may account for a cost or cost reductionin health care associated with the metric or the behavior as part ofcalculating an amount of health care credits to award to the individualbased on the metric or behavior.

At stage 1720, process 1700 associates one or more health care creditswith the individual, where the one or more HCCs correspond to the amountof HCCs or incentive points calculated in the previous stage. In theembodiment shown, the HCCs are associated with the individual byupdating a profile or data file associated with the individual. Invarious embodiments, the profile or data file may correspond to, beassociated with, or be part of, an HCC account, such as HCC account 136,143, 146, 310-325, or 360-375. In various embodiments, stage 1720 may beimplemented in manners similar to the embodiments described above withrespect to stage 1620 of FIG. 16.

At stage 1730, process 1700 creates a transferable financial instrumentassociated with the health care credit, where the instrument isrecognized as having value and is convertible to other forms of value.In various embodiments, the transferable financial instrument may be inelectronic form or in physical form. In various embodiments, thetransferable financial instrument may be a contractual right for theowner of the instrument to receive cash and/or health-care related goodsor services. In some embodiments, a party, who may be the issuer of thefinancial instrument (e.g., a health care insurer, health care provider,or other issuer of the financial instrument) may be obligated (forexample, legally obligated under the contract terms of the financialinstrument) to redeem the transferable financial instrument for cash inan amount, and under terms, specified by the instrument.

In some embodiments, stage 1730 may include obligating payment of anamount of cash derived from a health cost reduction associated with theindividual to an owner or holder of the transferable financialinstrument by a party benefitted by the health cost reduction, such as,for example, a private entity that provides or sponsors health insurance(such as a health insurance company) or a public entity that provides orsponsors health insurance (such as a government health insurer). Invarious embodiments, the party benefitted by the health cost reductionmay also be the issuer of the HCC/transferable financial instrument.

In some embodiments, stage 1730 may include obligating a partybenefitted by a health cost reduction associated with the individual(e.g., an insurer) to pay an amount derived from the health costreduction to a trust, where the trust is formed with an obligation topay the amount in cash to a holder or owner of the transferablefinancial instrument, either on demand or under specified contractualterms specified by the instrument. In some such embodiments, the partymay be obligated to pay the amount derived from the health costreduction to the trust in a series of payments over a defined period oftime.

One of ordinary skill in the art will recognize that process 1700depicted in FIG. 17 is an exemplary, generalized illustration and thatstages and features may be added to, removed from, or modified withinprocess 1700 without departing from the principles of the invention. Forexample, a stage may be added to transfer the transferable financialinstrument to the individual after receiving the data, such that, forexample, the individual owns the financial instrument and thus receivesan incentive for having or achieving the metric or performing thebehavior. For another example, a stage may be added to transfer thetransferable financial instrument to a health care provider afterreceiving the data, such that, for example, the health care providerowns the financial instrument and thus receives an incentive forproviding health care resulting in a positive metric or behavior. Insome embodiments, such a stage may be related to the health careprovider providing information or direction to the individual regardingthe individual's health or the behavior affecting the individual'shealth. For yet another example, stages may be added to create a trustthat is obligated to pay an amount derived from a health cost reductionassociated with the individual to a holder of the transferable financialinstrument, and to pay the amount derived from the health cost reductionto the trust.

FIG. 18 is a flowchart of an exemplary process 1800 associated with ahealth care credit market, consistent with embodiments of the invention.In some embodiments, process 1800 may be implemented by a computingsystem, for example, by a computing system provided by an insuranceprovider, an account provider, an account servicer, or the like, asdescribed in this specification and the incorporated-by-referenceapplications.

As shown, process 1800 begins with receiving data indicative of a metricof the health of a plurality of individuals or behaviors affecting thehealth of a plurality of individuals (stage 1810). In variousembodiments, the data indicative of a metric of the health of aplurality of individuals may be data gathered or generated as part ofhealth assessments of the individuals, for example, as described withrespect to FIGS. 4 and 5 of incorporated by reference application Ser.No. 13/273,430 and Ser. No. 13/273,366, which data may be received overa network. Examples of metrics of health include each individual'sweight, body mass index, blood pressure, cholesterol levels, currentillnesses or diseases, and the like, or a baseline health level.Similarly, in various embodiments, the data indicative of a behavioraffecting the health of the plurality of individuals may be datagathered or generated as part of health assessments, for example, asdescribed with respect to FIGS. 4 and 5 of incorporated by referenceapplication Ser. No. 13/273,430 and Ser. No. 13/273,366. Examples ofhealth-affecting behaviors include exercising, taking of medication,submitting to medical examination, eating healthy foods, reducingcalorie intake, reducing body weight, reducing body mass index, having adiagnostic exam, receiving a medical treatment, using a medical device,and ceasing smoking, and the like.

At stage 1815, process 1800 processes the data received in the previousstage to calculate an amount of health care credits to award to one ormore of the individuals, based on the metric or behaviors. In variousembodiments, stage 1815 may be implemented in manners similar to theembodiments described above with respect to stage 1615 of FIG. 16 andstage 1715 of FIG. 17.

At stage 1820, process 1800 associates the one or more health carecredits with the one or more of the individuals, where the one or moreHCCs correspond to the amount of HCCs or incentive points calculated inthe previous stage. In the embodiment shown, the HCCs are associatedwith the one or more of the individuals by updating a profile or datafile associated with the one or more of the individuals. In variousembodiments, the profile or data file may correspond to, be associatedwith, or be part of an HCC account, such as HCC account 136, 143, 146,310-325, or 360-375, or the like. In some embodiments, a single HCCaccount may be controlled by, and owned by, more than one individual,such as, for example, a family account for all the immediate members ofa family. In various embodiments, stage 1820 may be implemented inmanners similar to the embodiments described above with respect to stage1620 of FIG. 16 and stage 1720 of FIG. 17.

At stage 1830, process 1800 creates a plurality of transferablefinancial instruments representing the health care credits, wherein thetransferable financial instruments are owned by or transferred to one ormore of the individuals. In various embodiments, the transferablefinancial instruments may be in electronic form or in physical form. Invarious embodiments, each transferable financial instrument may be acontractual right for the owner of the instrument to receive cash and/orhealth-care related goods or services from the issuer or other obligatedparty. In some embodiments, a party such as a health care insurer orhealth care provider, who may be the issuer of a financial instrument ora beneficiary of the metric or behaviors, may be obligated to redeem thetransferable financial instrument for cash. In various embodiments, thestage 1830 may be implemented in manners similar to the embodimentsdescribed with respect to stage 1720 of FIG. 17.

At stage 1840, process 1800 enables the one or more of the individualsto transfer or use the transferable financial instruments by enablingthe one or more of the individuals to access the health care creditsover a network. In various embodiments, enabling the one or more of theindividuals to access the health care credits may include providing theindividuals with access to and control over an electronic accountcontaining the one or more health care credits. In various embodiments,the account may be an HCC account, such as HCC account 136, 143, 146,310-325, or 360-375, as described throughout this specification and theincorporated-by-reference applications. Further, in various embodiments,stage 1840 may be implemented in manners similar to the embodimentsdescribed with respect to stage 1630 of FIG. 16.

One of ordinary skill in the art will recognize that process 1800depicted in FIG. 18 is an exemplary, generalized illustration and thatstages and features may be added to, removed from, or modified withinprocess 1800 without departing from the principles of the invention. Forexample, modifications and additions similar to those described withrespect to FIGS. 16 and 17 may be made to process 1800.

FIG. 19 is a diagram illustrating an exemplary system for creating,transferring, and backing health care credits, consistent withembodiments of the invention. In the example shown, an HCC issuer 1910,such as a health insurance company or a government-sponsored healthinsurer, may issue electronic HCCs 1930 and/or physical HCCs 1930′ andtransfer the HCCs 1930/1930′ to an HCC account 1915 accessible by, andcontrolled by an individual 1905. As explained throughout thisspecification and the incorporated-by-reference applications, in variousembodiments, the HCC issuer 1910 may award or provide the HCCs to theindividual 1905 as a reward or incentive for health-benefitting behavioror achievement metric performed or received by individual 1905.

In the embodiment shown, HCCs may be implemented in the form ofelectronic transferable financial instruments (electronic HCCs 1930)and/or in the form of physical transferable financial instruments(physical HCCs 1930′), or in some combination of the two. In someembodiments, an electronic HCC 1930 may not have a correspondingphysical HCC 1930′. In some embodiments, physical HCC 1930′ may not havea corresponding electronic HCC 1930′. In other embodiments, physical HCC1930′ may be the definitive legal document that evidences the rights andobligations of the HCC owner and issuer, like a paper stock certificateor paper bond certificate, and physical HCC 1930′ may have acorresponding electronic HCC 1930 that represents the physical HCC 1930′to the owner (e.g. individual 1905) and other parties in electronicaccount systems, electronic trading systems, etc., similar to anelectronic stock brokerage account.

In various embodiments, the HCC issuer 1910 may be obligated under theterms of the HCC financial instrument 1930/1930′ to provide cash and/orhealth-care related goods or services to the owner of the HCC financialinstrument 1930/1930′. In various embodiments, the amount of cash and/orhealth-care related goods or services may be related to a cost or costsavings associated with the health-benefitting behavior or achievementmetric performed or received by individual 1905, as described throughoutthis specification and the incorporated-by-reference applications. Invarious embodiments, HCC issuer 1910 may be desired or required, forexample by the terms of HCC financial instrument 1930/1930′, to setup,provide, or maintain financial backing for the HCC financial instrument1930/1930′, according to an initial issuing value of HCC financialinstrument 1930/1930′. In some embodiments, the HCC issuer 1910 mayinternally provide for the financial backing for the HCC financialinstrument 1930/1930′, for example by maintaining an internal cashreserve equivalent to the initial cash value of the HCC, or by budgetingfor payment of the initial amount from future revenues.

In other embodiments, the HCC issuer 1910 may use a separate entity forthe financial backing for the HCC financial instrument 1930/1930′, suchas trust 1920 as shown in the embodiment of FIG. 19. In suchembodiments, the HCC issuer 1910 may provide cash 1925 to fund the trust1920 (as represented by the dashed arrow), and the trust 1920 may beorganized and obligated to pay out cash 1925 to the owner of the HCCfinancial instrument 1930/1930′ according to the terms of the HCCfinancial instrument 1930/1930′. The HCC issuer 1910 may initially fundthe trust 1920 with an amount of cash 1925 equivalent to the initialvalue of the HCC financial instrument 1930/1930′, as noted above.

The system shown in FIG. 19 also includes a health care credits exchangenetwork 1010, which may be composed of one or more issuers, individuals,and health care providers, among other things. In general, health carecredits exchange network 1010 is a network of entities that transfer,buy, sell, exchange, etc. HCCs 1930/1930′ amongst each other. As shown,individual 1905 may be connected to, and thus part of, the health carecredits exchange network 1010 by virtue of interacting with health carecredits exchange network 1010 via the HCC account 1915. Similarly, theHCC issuer 1910 may be part of the health care credits exchange network1010.

In the embodiment shown, an entity that is part of the health carecredits exchange network 1010 may redeem or sell HCC financiallyinstruments 1930/1930′ to the HCC issuer 1910 in exchange for an amountof cash 1925 (or in some embodiments, goods or services) according toterms specified by the HCC financially instruments 1930/1930′. As shown,in some embodiments, as represented by the solid arrow from the HCCissuer 1910 to the HCC exchange network 1010, the HCC issuer 1910 maydirectly pay the cash 1925 to the owner of the redeemed HCC financialinstruments 1930/1930′. In other embodiments, as represented by thedashed arrow from the HCC issuer 1910 to the trust 1920, and from thetrust 1920 to the HCC exchange network 1010, the HCC issuer 1910 mayhave paid the cash 1925 to the trust 1920 at an earlier time, such as atissuance, and the trust 1920 may later pay the cash 1925 to the owner ofthe redeemed HCC financial instruments 1930/1930′ according to the termsof HCC financial instrument 1930/1930′.

In various embodiments, the amount of cash 1925 obligated to be paid tothe owner of the HCC financial instrument 1930/1930′ by the terms of HCCfinancial instrument 1930/1930′ may be different than the market valueof the HCC financial instrument 1930/1930′ among the entities of HCCexchange network 1010. In various market situations, the supply anddemand of HCCs 1930/1930′ in the HCC exchange network 1010 may maketheir market price substantially higher or lower than their price atissuance and/or their price as specified by the terms of HCC financialinstrument 1930/1930′.

One of ordinary skill in the art will recognize that system 100 depictedin FIG. 1 is an exemplary, generalized illustration and that componentsand features may be added to, removed from, or modified within system100 without departing from the principles of the invention. For oneexample, an entity may be inserted between HCC Issuer 1910 and HCCaccount 1915, which converts non-transferable credits or incentivepoints issued by HCC Issuer 1910 into HCCs that are transferablefinancial instruments.

The processing of a method, process, or algorithm described inconnection with the implementations disclosed herein may be embodieddirectly in hardware, in a software module executed by a processor, orin a combination of the two. A software module may reside in RAM memory,flash memory, ROM memory, EPROM memory, EEPROM memory, registers, a harddisk, a removable disk, a CD-ROM, or any other form of storage mediumknown in the art. In some embodiments, the storage medium may beintegral to the processor. The processor and the storage medium mayreside in an ASIC. The ASIC may reside in a computing device orcomputing system.

Other embodiments of the invention will be apparent to those skilled inthe art from consideration of the specification and practice of theinvention disclosed herein. It is intended that the specification andexamples be considered as exemplary only, with a true scope and spiritof the invention being indicated by the following claims.

What is claimed is:
 1. A method, implemented using a server system, for facilitating health care credit transactions, the method comprising: receiving via a network, at a server system, information indicating health care credits calculated and awarded based on data indicative of individuals' health or behaviors affecting individuals' health; associating the health care credits with entities by updating, at a database in communication with the server system, profiles or data files associated with the entities; enabling access, over the network, to one or more accounts containing the health care credits; receiving via the network, at the server system a first indication, the first indication indicating a desire or permission to transfer an interest in one or more health care credits; and receiving via the network, at the server system a second indication, the second indication indicating a desire to receive the interest in the one or more health care credits; in response to the first indication and the second indication, executing, using the server system and the database, a transaction to transfer the one or more health care credits from an account associated with the first indication. 